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Comparison of propofol–alfentanil and propofol–remifentanil anaesthesia in percutaneous nephrolithotripsy

Published online by Cambridge University Press:  26 August 2005

M. Cicek ,
A. Koroglu ,
S. Demirbilek ,
H. Teksan  and
M. O. Ersoy
M. Cicek
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
A. Koroglu
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
S. Demirbilek
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
H. Teksan
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
M. O. Ersoy
Affiliation:
Medical School of Inonu University, Department of Anaesthesiology, Malatya, Turkey
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Summary

Background and objective: Percutaneous nephrolithotripsy (PCNL) is used for the fragmentation and removal of stones from the renal pelvis and renal calyceal systems. We compared the effects of propofol–alfentanil or propofol–remifentanil anaesthesia on haemodynamics, recovery characteristics and postoperative analgesic requirements during percutaneous nephrolithotripsy. Methods: Thirty non-premedicated patients were randomly allocated to receive either propofol–alfentanil (Group A) or propofol–remifentanil (Group R). The loading dose of the study drug was administered over 60 s (alfentanil 10 μg kg−1 or remifentanil 1 μg kg−1) followed by a continuous infusion (alfentanil 15 μg kg−1 h−1 or remifentanil 0.15 μg kg−1 min−1). Propofol was administered until loss of consciousness and maintained with a continuous infusion of 75 μg kg−1 min−1 in both groups. Atracurium was given for endotracheal intubation at a dose of 0.5 mg kg−1 and maintained with a continuous infusion of 0.4 mg kg−1 h−1. Mean arterial pressure heart rate, the total amount of propofol, time of recovery of spontaneous ventilation, extubation and eye opening in response to verbal stimulus and analgesic requirement were recorded. Results: In Group A, mean arterial pressure was higher at the first minute in the prone position, and during skin incision and lithotripsy, and heart rate was higher during skin incision and lithotripsy when compared with Group R (P < 0.05). The total amount of propofol did not differ between groups. Time of recovery of spontaneous ventilation, extubation and eye opening were significantly shorter in Group R than Group A (P < 0.05). Conclusions: Both propofol–remifentanil and propofol–alfentanil anaesthesia provided stable haemodynamics during percutaneous nephrolithotripsy, whereas propofol–remifentanil allowed earlier extubation.

Keywords

ANAESTHETICS, INTRAVENOUS, propofol, alfentanil, remifentanilSURGICAL PROCEDURES, urological, percutaneous nephrolithotripsyHAEMODYNAMIC PHENOMENA, blood pressure, heart rateANAESTHESIA RECOVERY PERIOD
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 9 , September 2005 , pp. 683 - 688
Copyright
© 2005 European Society of Anaesthesiology

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