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Remifentanil versus alfentanil in total intravenous anaesthesia for day case surgery

Published online by Cambridge University Press:  02 June 2005

I. Alper ,
E. Erhan ,
G. Ugur  and
B. Ozyar
I. Alper
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bornova, İzmir, Turkey
E. Erhan
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bornova, İzmir, Turkey
G. Ugur
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bornova, İzmir, Turkey
B. Ozyar
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bornova, İzmir, Turkey
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Extract

Summary

Background and objective: We assessed the intraoperative haemodynamic responses and recovery profiles of total intravenous anaesthesia with remifentanil and alfentanil for outpatient surgery.

Methods: Patients in Group 1 (n = 20) received alfentanil 20 μg kg−1 followed by 2 μg kg−1 min−1 intravenously; patients in Group 2 (n = 20) received remifentanil 1 μg kg−1 followed by 0.5 μg kg−1 min−1 intravenously. Both groups then received propofol 2 mg kg−1 followed by 9 mg kg−1 h−1 intravenously. Five minutes after skin incision, infusion rates were decreased, and at the end of surgery, all infusions were discontinued. Early recovery was assessed by the Aldrete score, whereas intermediate recovery was assessed with the postanaesthetic discharge scoring system (PADS).

Results: Perioperative arterial pressure was similar in both groups; heart rate was lower in Group 2 (P < 0.05). The times to spontaneous and adequate respiration, response to verbal commands, extubation and times for Aldrete score ≥9 were shorter in Group 2 patients (P < 0.05). Pain scores were higher in Group 2 patients (P < 0.05). Overall times for postanaesthetic discharge scores ≥9 were similar.

Conclusions: Early recovery of patients after day surgery is significantly shorter after total intravenous anaesthesia with remifentanil compared with that with alfentanil but postoperative pain management must be planned ahead.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolANAESTHETICS, INTRAVENOUS, remifentanil, alfentanilANAESTHETICS TECHNIQUES, infusion
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 1 , January 2003 , pp. 61 - 64
Copyright
© 2003 European Society of Anaesthesiology

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