A retrospective study of analgesia efficacy and its side effect in 127 patients undergoing selective neurosurgery

Abstract

Objective To investigate the analgesia efficacy and the impact of age on it after selective craniectomy, and to study risk factors of analgesia side effects. Methods One hundred and twenty-seven patients undergoing selective craniectomy were enrolled in this study. All patients were administered with fentanyl and ondansetron to produce continuous intravenous postoperative analgesia. Patients were evaluated by Visual Analog Score (VAS), Ramsay score and the impact on their mobility status. Heart rate (HR), mean blood pressure (MBP) and respiratory rate (RR) were recorded at preoperative time, and 24 h and 48 h after operation. We mainly focused on the incidence of postoperative pain and side effects of analgesia (such as nausea and vomiting, urinary retention, pruritus and exhaust time). Results There were statistic differences in MBP and RR among 3 groups (P = 0.000, for all), but all within normal range. Total rate of excellent analgesia was 84.25% (107/127), and there was no statistic difference in VAS among 3 groups (P > 0.05, for all). The VAS (at rest and mobility status) at 48 h was significantly lower than at 24 h after surgery (P = 0.000, for all). Total incidence of postoperative nausea and vomiting (PONV) was 29.13% (37/127), and total incidence of urinary retention was 14.96% (19/127). There was no statistic difference in the incidence of PONV and urinary retention among 3 groups (P > 0.05, for all). The risk factor of PONV was gender (P = 0.022). American Society of Anesthesiologists (ASA) score was related to mental state (rs = 0.202, P = 0.023) and mobility status (rs = 0.221, P = 0.013). Age was related to mental state (rs = 0.945, P = 0.015) and mobility status (rs = 0.940, P = 0.020). ASA score also had a correlation with pruritus (rs = 0.212, P = 0.017). Conclusion Fentanyl combined with ondansetron can produce a good continuous intravenous postoperative analgesia for patients undergoing craniectomy. The risk factor of PONV is gender. Mental state and mobility status are related to ASA score and age.

DOI:10.3969/j.issn.1672-6731.2011.04.017