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Alfentanil Combined With Morphine Gives Quicker Pain Relief in Recovery Room Than Morphine Alone: Presented at AAPM

By Ed Susman

KISSIMMEE, FL -- February 19, 2008 -- The combination of the fentanyl analogue alfentanil (Alfenta) with morphine provides faster pain relief for patients in the recovery room following surgery compared with morphine alone.

Median time to achieve pain relief was 23 minutes with alfentanil 1 mg plus morphine 10 mg (ALFINE) compared with 30 minutes for morphine alone (P < .01), reported Liza Tharakan, MBBS, DA, Anaesthesiologist, University Hospital Lewisham, London, United Kingdom.

Dr. Tharakan presented the study findings in a poster session on February 14 here at the American Academy of Pain Medicine (AAPM) 24th Annual Meeting.

Dr. Tharakan and colleagues assigned 50 adults undergoing general, gynaecological, orthopaedic, or ear, nose, and throat surgeries to receive ALFINE and compared the results with those seen in a similar trial that scrutinised the same type of patients whose postoperative pain was treated with morphine alone.

When they were admitted to the postanaesthesia care unit, patients were given 2 mL of the solution if they were aged less than 70 years, had severe pain, weighed more than 50 kg, and had adequate blood pressure and lung function. A solution containing 1 mL of the drug was provided to patients with less severe pain, those aged 70 years or older, and those with compromised blood pressure and lung function.

Verbal rating pain scores and vital signs were recorded at baseline and at discharge. Patients were interviewed on the first postoperative day for initial pain, speed of onset of pain relief, and overall satisfaction on a verbal rating scale.

"Even though ALFINE was equally efficacious and had twice the potency of morphine alone, we did not find it to be a cost-effective treatment," Dr. Tharakan said. "Nevertheless, we suggest that the better patient satisfaction and onset of analgesia scores of ALFINE would favour its use as patient-controlled anaesthesia."


[Presentation title: Alfentanil-Morphine (ALFINE) in Postoperative Pain. Abstract 108]

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