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Inflammation affects sufentanil consumption in ulcerative colitis

Published online by Cambridge University Press:  01 March 2008

M. Fleyfel ,
C. Dusson ,
M.-L. Ousmane ,
A. Guidat ,
J. F. Colombel ,
L. Gambiez  and
B. Vallet
M. Fleyfel*
Affiliation:
CHRU de Lille, Federation of Anesthesiology and Intensive Care Medecine, Lille Cedex, France
C. Dusson
Affiliation:
CHRU de Lille, Federation of Anesthesiology and Intensive Care Medecine, Lille Cedex, France
M.-L. Ousmane
Affiliation:
CHRU de Lille, Anesthésie Réanimation Huriez, Lille Cedex, France
A. Guidat
Affiliation:
CHRU de Lille, Federation of Anesthesiology and Intensive Care Medecine, Lille Cedex, France
J. F. Colombel
Affiliation:
CHRU de Lille, Department of Gastro-Enterology, Lille Cedex, France
L. Gambiez
Affiliation:
CHRU de Lille, Department of Gastro-Enterology, Lille Cedex, France
B. Vallet
Affiliation:
CHRU de Lille, Federation of Anesthesiology and Intensive Care Medecine, Lille Cedex, France
*
Correspondence to: Maher Fleyfel, Federation of Anesthesiology and Intensive Care Medecine, CHRU de Lille, Lille Cedex, France. E-mail: [email protected]; Tel: +33 3 2044 5196; Fax: +33 3 2044 6365
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Summary

Background

Previous studies have demonstrated an increased perioperative opioid requirement during inflammatory disease. To evaluate the influence of the inflammatory process, we studied in the same patient the sufentanil requirement during procedures that occur during two distinct phases of ulcerative colitis with different inflammatory profiles: (1) left colectomy for major colitis unresponsive to medical treatment during acute inflammation and (2) coloprotectomy with ileoanal anastomosis, three months after recovery of the acute inflammatory episode.

Methods

Sixteen patients with clinical and histological evidence of ulcerative colitis scheduled for colectomy with ileoanal anastomosis were included. For each surgical procedure, anaesthesia was induced with sufentanil 0.5 μg kg−1 and propofol 2 mg kg−1. Patients were ventilated with 50% nitrous oxide and oxygen, and tidal volume was adjusted to keep end-tidal CO2 at 30 mmHg. Anaesthesia was maintained with end-tidal isoflurane at 0.5%. Analgesia was achieved with continuous infusion of sufentanil at 0.3 μg kg−1 h−1. Additional boluses of sufentanil and increases in infusion rates were used when haemodynamic variables increased to more than 20% of preoperative values. Sufentanil consumption during surgery was analysed by Wilcoxon signed rank sum test. P < 0.05 was considered significant.

Results

Total intra-operative sufentanil requirement was significantly larger during colectomy performed for acute inflammatory colitis than during ileoanal anastomosis performed after the inflammatory process (1.24 ± 0.48 μg kg−1 h−1 vs. 0.62 ± 0.3 μg kg−1 h−1; P < 0.05).

Conclusion

For the same patient, inflammatory status influences opioid requirements during surgery for ulcerative colitis.

Keywords

PAIN ACUTE AND POSTOPERATIVEANALGESICS OPIOIDINFLAMMATORY BOWEL DISEASESURGICAL PROCEDURES, abdominal
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 3 , March 2008 , pp. 188 - 192
Copyright
Copyright © European Society of Anaesthesiology 2008

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