Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T16:05:37.140Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

Extract

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

From RP, Warner DS, Todd MM, Sokoll MD. Anesthesia for craniotomy: a double-blind comparison of alfentanil, fentanyl and sufentanil. Anesthesiology 1990; 73: 896–904.Google Scholar
Van Hemelrijck J, Van Aken H, Merckx L, Mutier J. Anesthesia for craniotomy: total intravenous anesthesia with propofol and alfentanil compared to anesthesia with thiopental sodium, fentanyl and nitrous oxide. J Clin Anesth 1991; 3: 131–136.Google Scholar
Glass PSA, Hardman D, Kamiyama Y et al. Preliminary pharmacokinetics and pharmacodynamics of an ultra-short acting opioid: remifentanil (GI87084B). Anesth Analg 1993; 77: 1031–1040.Google Scholar
Hogue Jr CW, Bowdle TA, O'Leary C et al. A multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery. Anesth Analg 1996; 83: 279–285.Google Scholar
Fernström I, Johansson B. Percutaneous pyelolithotomy, a new extraction technique. Scand J Urol Nephrol 1976; 10: 257–259.Google Scholar
Alken P, Hutschenreiter G, Gunther R, Marberger M. Percutaneous stone manipulation. J Urol 1981; 125: 463–466.Google Scholar
Cariou G, Le Duc A, Serrie A, Cortesse A, Teillac P, Ziegler F. Reabsorption of the irrigation solute during percutaneous nephrolithotomy. Ann Urol 1985; 19:83–86.Google Scholar
Sugai K, Sugai Y, Azuma Y, Tanaka Y, Miyazaki M. Vascular absorption of irrigation solution in percutaneous nephro-ureterolithotomy. Br J Anaesth 1988; 61: 516–517.Google Scholar
Egan TD, Minto C, Lemmens HJM et al. Remifentanil vs. alfentanil: comperative pharmacodynamics [Abstract]. Anesthesiology 1994; 81: A374.Google Scholar
Guy J, Hindman BJ, Baker KZ et al. Comparison of remifentanil and fentanyl in patients undergoing craniotomy for supratentorial space-occupying lesions. Anesthesiology 1997; 86: 514–524.Google Scholar
Coles JP, Leary TS, Monteiro JN et al. Propofol anesthesia for craniotomy: a double-blind comparison of remifentanil alfentanil, and fentanyl. J Neurosurg Anesthesiol 2000; 12: 15–20.Google Scholar
Gerlach K, Uhlig T, Hüppe M et al. Remifentanil–propofol vs. sufentanil–propofol anaesthesia for supratentorial craniotomy: a randomized trial. Eur J Anaesthesiol 2003; 20: 813–820.Google Scholar
Kapila A, Glass PSA, Jacobs JR et al. Measured context-sensitive half-times of remifentanil and alfentanil. Anesthesiology 1995; 83: 968–975.Google Scholar
Schüttler J, Albbrecht S, Breivik H et al. A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery. Anaesthesia 1997; 52: 307–317.Google Scholar
Balakrishnan G, Raudzens P, Samra SK et al. A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions. Anesth Analg 2000; 91: 163–169.Google Scholar
Todd MM, Warner DS, Sokoll MD et al. A prospective, comparative trial of three anesthetics for elective supratentorial craniotomy. Propofol/fentanyl, isoflurane/nitrous oxide, and fentanyl/nitrous oxide. Anesthesiology 1993; 78: 1005–1020.Google Scholar
Tramer M, Moore A, McQuay H. Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies. Br J Anaesth 1997; 78: 247–255.Google Scholar
Loop T, Priebe HJ. Recovery after anesthesia with remifentanil combined with propofol, desflurane, or sevoflurane for otorhinolaryngeal surgery. Anesth Analg 2000; 91: 123–129.Google Scholar