Comparison of Fentanyl with Sufentanil for Chest Tube Removal

Background: After cardiac surgery, the chest tubes cause pain and their removal is painful and unpleasant for patients. The aim of this research was to study and compare the analgesic effect of fentanyl and sufentanil on pain relief during chest tube removal in post-cardiac surgical patients. Patients and Methods: A total of 80 patients scheduled for elective cardiac surgery, were recruited in prospective, randomized and double-blind study. Patients received 1.5µg/kg fentanyl or 0.15µg/kg sufentanyl, intravenously 10 minutes before removal of chest tube. Pain intensity was assessed by measuring visual analog scale (VAS) pain score, 10 minutes before, during, and 5 and10 minutes after removing chest tubes. Level of sedation, heart rate, arterial blood pressure, and oxygenation saturation were recorded at each stage by a blinded observer. Results: Mean pain intensity scores 10 minutes before removal of chest tube in fentanyl, and sufentanil groups were 29.5±12.1 and 31±11.2 respectively. Pain scores during che t tube removal were 38.5±11.6 in fentanyl group and 44.7±12.8 in sufentanil group (P =0.02). In addition, pain scores during chest tube removal were sig nificantly (P value=0.02) more reduced in fentanyl (17.21±7.5) than in sufentanil group (21.51±11.2). Sedation scores remained low in two groups. None of the patients showed any adverse side effects of opioids. No differ ences were seen in the heart rate or arterial blood pressure, but oxygenation saturation was significantly greater in sufentanil group than in fentanyl group. Conclusion: Both fentanyl and sufentanil provide adequate analgesia for chest tube removal without increasing untoward side effects.