Objectives
This study aimed to compare the effect of nebulized fentanyl with intravenous fentanyl for
postoperative analgesia after unilateral arthroscopic anterior cruciate ligament reconstruction
surgery.
Patients and methods
A total of 87 patients scheduled for unilateral arthroscopic anterior cruciate ligament
reconstruction surgery under regional anesthesia were enrolled in the study and were
randomly allocated into two groups. Group IV included 42 patients who received 2 μg/kg of
fentanyl intravenously, and Group N included 45 patients who received 4 μg/kg of fentanyl
nebulization using a standard ventimask. Both groups received the analgesic drug through
either intravenously or nebulization route whenever the patient reported pain for the fi rst time
in the postanesthesia care unit that was of a score greater than 4 on the visual analog scale.
Observations were made for the onset and duration of analgesia, number of patients who
were not relieved of pain even 15 min after analgesia administration, level of sedation using
the Ramsay sedation scale, and side effects.
Results
Both groups were similar in terms of demographic characteristics and duration of surgery. The
onset of analgesia was signifi cantly delayed in group N in comparison with group IV, whereas
the duration of analgesia was signifi cantly longer in group N in comparison with group IV. In
group IV, the Ramsay sedation score was the maximum at 5 min. In group N, there was a slow
rise in the sedation score, but it was always less than that in group IV. Side effects in group
N were less compared with group IV, and the number of patients who developed bradycardia
was signifi cantly higher in group IV.
Conclusion
This study showed that nebulization with fentanyl is a good alternative to intravenous fentanyl
for adequate postoperative pain relief with fewer side effects.