ArticlePerioperative medicine (London, England)2025
Intraoperative fentanyl in endoscopic procedures and their impact on PACU time and costs.
Article in Perioperative medicine (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- A two-phase randomized study of oliceridine versus sufentanil for gastrointestinal endoscopy.Frontiers in pharmacology · 2026Trial
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtended stays in the postanesthesia care unit (PACU) pose challenges in high-volume endoscopies. This study investigates the impact of intraoperative fentanyl use on PACU duration, postoperative pain, and financial implications in outpatient endoscopy.
methodA retrospective analysis of upper/lower endoscopies at our facility (2020-2022) was conducted, focusing on the relationship between fentanyl use, PACU duration, and pain scales. Financial impacts were also assessed.
resultsAmong 11,488 patients, 5787 (50.4%) received intraoperative fentanyl, and 5225 (45.5%) had a long stay at PACU (> 50 min). A larger proportion of patients in the long-stay group (> 50 min) received fentanyl (56.3% vs. 45.4%, P < 0.01), and they reported higher Numeric Rating Scale (NRS) pain scores (> 5 in 3.6% vs. 1.2%, P < 0.01). The median PACU time was longer for fentanyl recipients (52 vs. 48 min, P < 0.01). Multivariable analysis identified fentanyl use, older age, and higher ASA scores (≥ 3) as significant factors for prolonged PACU durations. Fentanyl did not significantly reduce postoperative pain (scores > 5: 2.8% for fentanyl users vs. 2.2% for nonusers). Furthermore, most patients reported no pain post-surgery (93.0% for fentanyl users vs. 95.2% for nonusers). Fentanyl recipients did not have shorter PACU stays within any pain scale category. Financial simulations suggest that fentanyl-free anesthesia management could notably decrease the financial burden within endoscopy operations. Specifically, our institution could have realized an annual saving of at least US $100,308.
conclusionIntraoperative fentanyl increases PACU duration by approximately 4 min per patient in endoscopies, without markedly improving pain management. Avoiding fentanyl could lead to significant time and cost savings.
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