Comparison of the Efficacy and Safety of a Pharmacokinetic Model-Based Dosing Scheme Versus a Conventional Fentanyl Dosing Regimen For Patient-Controlled Analgesia Immediately Following Robot-Assisted Laparoscopic Prostatectomy: A Randomized Clinical Trial

Medicine
Seok-Joon JinYoung-Kug Kim

Abstract

Conventional, intravenous, patient-controlled analgesia, which is only administered by demand bolus without basal continuous infusion, is closely associated with inappropriate analgesia. Pharmacokinetic model-based dosing schemes can quantitatively describe the time course of drug effects and achieve optimal drug therapy. We compared the efficacy and safety of a conventional dosing regimen for intravenous patient-controlled analgesia that was administered by demand bolus without basal continuous infusion (group A) versus a pharmacokinetic model-based dosing scheme performed by decreasing the dosage of basal continuous infusion according to the model-based simulation used to achieve a targeted concentration (group B) following robot-assisted laparoscopic prostatectomy.In total, 70 patients were analyzed: 34 patients in group A and 36 patients in group B. The postoperative opioid requirements, pain scores assessed by the visual analog scale, and adverse events (eg, nausea, vomiting, pruritis, respiratory depression, desaturation, sedation, confusion, and urinary retention) were compared on admission to the postanesthesia care unit and at 0.5, 1, 4, 24, and 48 h after surgery between the 2 groups. All patients were kept for close ...Continue Reading

References

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Dec 1, 1996·Anesthesiology·B GinsbergS L Shafer
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Mar 6, 2004·Orthopaedic Nursing·Mary E HagleAngela Shippee

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Citations

May 5, 2016·Paediatric Drugs·Hedy MaagdenbergAnke H Maitland-van der Zee
Jul 2, 2021·Anaesthesia Critical Care & Pain Medicine·Adrien LemoineUNKNOWN PROSPECT Working Group Of The European Society Of Regional Anaesthesia And Pain Therapy (ESRA)

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Methods Mentioned

BETA
PCA
sedation

Clinical Trials Mentioned

NCT02402621

Software Mentioned

NONMEM
SPSS
R
SigmaStat

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