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 chest 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 significantly
(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 differences
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.