BACKGROUND AND OBJECTIVES: Moderate to severe postoperative pain control is still a daily problem due to pain in the intervals between analgesic administration and adverse effects. Percutaneous fentanyl induces continuous analgesia for up to 72 hours and has been used to control acute pain. This study aimed at evaluating percutaneous fentanyl analgesia to control acute postoperative pain in patients submitted to spinal arthrodesis, as well as at observing the incidence of fentanyl-related adverse effects. METHOD: Participated in this study 9 patients submitted to spinal arthrodesis under general anesthesia with propofol, sufentanil and cisatracurium and maintenance with remifentanil and isoflurane. One 12 µg/h percutaneous fentanyl adhesive was applied before surgery and ketoprofen, dipirone and tramadol were administered at surgery completion. Dipirone was administered every 6 hours as rescue analgesic drug. Pain intensity was evaluated every 12 hours by the visual analog scale and dipirone and ketoprofen consumption in 12-hour intervals; adverse effects were recorded. RESULTS: Twelve hours after adhesive application, mean pain intensity was 2.11 ± 2.84. Highest pain intensity was observed 60 hours after adhesive application and lowest value was observed 24 and 72 hours after percutaneous fentanyl adhesive application. Highest total dipirone consumption was 8000 mg in the period between 60 and 72 hours and between 36 and 48 hours and the lowest consumption was zero mg in the period between 60 and 72 hours, but there has been no statistically significant difference in observed periods (p = 0.47). Side effects were one case of sleepiness and one of nausea and vomiting. CONCLUSION: This study results suggest that percutaneous fentanyl is safe and effective for postoperative spinal surgery pain. Results have also shown that percutaneous fentanyl has minor side effects.
Analgesia; Arthrodesis; Fentanyl; Percutaneous adhesive; Spine
