Evaluation of pain following electrocautery tubal ligation and effect of intraoperative fentanyl

Abstract

Study Objective: To evaluate pain following laparoscopic tubal sterilization (LTS) and the effects of supplemental intraoperative fentanyl. Design: Open evaluation of pain intensity and opioid requirements with double-blind, randomized evaluation of intraoperative fentanyl. Setting: Outpatient center of a university-affiliated teaching hospital. Patients: 44 ASA status I patients who underwent LTS by electrocautery. Interventions: Patients received either intravenous fentanyl (F) 1 μg/kg or saline (S) at induction. Measurements and Main Results: Pain intensity was measured with patient assessments of visual analog scales (VAS) and cumulative opioid requirements. The group that received intraoperative fentanyl received 70.2 ± 3.7 μg at induction. VAS on postanesthesia care unit arrival was 4.9 ± 0.5 (F) and 5.9 ± 0.5 (S) (means ± SEM). VAS after one hour was 2.1 ± 0.2 in both groups. During that hour, the F group consumed 107.5 ± 14. 7 μg and the S group consumed 140.5 + 15.7 μg fentanyl. The range of fentanyl consumed by each group in the postoperative period was 0 to 250 μg. There were no statistically significant differences between the F and S groups. Conclusions: Pain following LTS by electrocautery is of significant magnitude and may require relatively large doses of opioids for adequate management. Supplemental intraoperative fentanyl 1 μg/kg did not produce a clinically significant reduction in either pain scores or opioid requirements.