Comparison between Intravenous and Epidural Injections of Fentanyl in Critically Ill Patients with Thoracic Trauma:Effects on Pain Level, Static Pulmonary Compliance, and Arterial Blood Gas
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Background: The aim of present study is to compare the effects of epidural and intravenous injections of fentanyl on level of pain, lungs static compliance, and PaO2 in patients with thoracic trauma and surgery.
Methods: We studied 60 patients (age between 18 to 60 years) who were under mechanical ventilation due to their thoracic traumas. In order to reduce pain, patients randomly divided into two groups: group "E" whom received epidural injections of fentanyl (1 μg/kg/h); and group "I" whom received their fentanyl via intravenous injection (2 μg/kg/h) for 24 hours after admission in intensive care unit (ICU). Level of pain, static pulmonary compliance and PaO2 were recorded at 0, 2, 6, and 24 hours after ICU admission.
Results: In the first two hours after ICU admission, patients in group "E" experienced more pain and had lower level of PaO2 and lungs static compliance compared to the patients of group "I". Two hours after admission, score of behavioral pain scale decreased in patients of group "E" more than patients of group "I". The level of PaO2 and static pulmonary compliance also increased in patients of group "E" more than patients of group "I". This situation continued during the further times; i.e. 6 and 24-hour.
Conclusion: Our results revealed that in order to control the pain, increased lung compliance, and PaO2 in patients with thoracic trauma, we could use both intravenous and epidural injection of fentanyl simultaneously.
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