Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery
| العنوان: | Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery |
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| المؤلفون: | Tomohiro Koyama, Toshiyuki Mizota, Tsutomu Shichino, Yoko Mizota, Yoshika Iwata |
| المصدر: | Journal of Anesthesia. 26:503-508 |
| بيانات النشر: | Springer Science and Business Media LLC, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Adult, Laparoscopic surgery, medicine.medical_specialty, Adolescent, Nausea, medicine.medical_treatment, Orthostatic intolerance, Body Mass Index, Fentanyl, Cohort Studies, Young Adult, Gynecologic Surgical Procedures, Postoperative Complications, medicine, Humans, Infusions, Intravenous, Early Ambulation, Aged, Retrospective Studies, Postoperative Care, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Analgesics, Opioid, Treatment Outcome, Anesthesiology and Pain Medicine, Blood pressure, Anesthesia, Ambulatory, Anesthesia, Intravenous, Orthostatic Intolerance, Vomiting, Female, Laparoscopy, medicine.symptom, business, medicine.drug |
| الوصف: | [Purpose]: Early ambulation is essential for rapid functional recovery after surgery; however, orthostatic intolerance may delay recovery and cause syncope, leading to potential serious complications such as falls. Opioids may contribute to orthostatic intolerance because of reduced arterial pressure and associated reduction in cerebral blood flow and oxygenation. This study aimed to examine the effect of postoperative continuous infusion of fentanyl on orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery. [Methods]: In this retrospective cohort study, data from 195 consecutive patients who underwent gynecologic laparoscopic surgery were analyzed to evaluate the association between postoperative continuous infusion of fentanyl and the incidence of orthostatic intolerance or delayed ambulation. The primary outcome was defined as delayed ambulation, an inability to ambulate on postoperative day 1. The secondary outcome was defined as orthostatic intolerance and symptoms associated with ambulatory challenge, including dizziness, nausea and vomiting, feeling hot, blurred vision, and eventual syncope. Multivariate logistic regression was used to determine the independent predictors of delayed ambulation and orthostatic intolerance. [Results]: There were 24 cases with documented orthostatic intolerance and 5 with delayed ambulation. After multivariate logistic regression modeling, postoperative continuous infusion of fentanyl was found to be significantly associated with both orthostatic intolerance [adjusted odds ratio (95 % confidence interval), 34.78 (11.12–131.72)] and delayed ambulation [adjusted odds ratio (95 % confidence interval), 8.37 (1.23–72.15)]. [Conclusion]: Postoperative continuous infusion of fentanyl is associated with increased orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery. |
| وصف الملف: | application/pdf |
| تدمد: | 1438-8359 0913-8668 |
| DOI: | 10.1007/s00540-012-1391-9 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3dcdf97ea53ca667745fd5cd31b0b093 https://doi.org/10.1007/s00540-012-1391-9 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3dcdf97ea53ca667745fd5cd31b0b093 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14388359 09138668 |
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| DOI: | 10.1007/s00540-012-1391-9 |