A comparison of remifentanil and fentanyl in patients undergoing carotid endarterectomy.
OBJECTIVE
We investigated the haemodynamic stability and emergence characteristics of isoflurane/nitrous oxide anaesthesia supplemented with remifentanil or fentanyl in patients undergoing carotid endarterectomy.


METHODS
Anaesthesia was induced with propofol (1-2 mg kg-1) and either remifentanil (0.5 microgram kg-1) or fentanyl (1 microgram kg-1), followed by an infusion of remifentanil (0.2 microgram kg-1 min-1) or fentanyl (2 micrograms kg-1 h-1).


RESULTS
There were no significant differences between the groups in haemodynamic variables, postoperative pain, nausea or vomiting. After induction there was a significant decrease in mean arterial pressure for both groups (P < 0.001) and a decrease in heart rate (P = 0.001) in the remifentanil group. In both groups these haemodynamic changes continued during maintenance of anaesthesia (P < 0.05). The time to eye opening after surgery was significantly shorter with remifentanil compared with fentanyl (6.62 +/- 3.89 vs. 18.0 +/- 15.18 min, P = 0.015).


CONCLUSIONS
Remifentanil appears to be a comparable opioid to fentanyl when supplementing isoflurane/nitrous oxide anaesthesia for carotid endarterectomy.
Department of Anaesthesia, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
P W
PW
Doyle
J P
JP
Coles
T M
TM
Leary
P
P
Brazier
A K
AK
Gupta
D000759:Adjuvants, Anesthesia; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D003250:Constriction; D004311:Double-Blind Method; D016894:Endarterectomy, Carotid; D005260:Female; D005283:Fentanyl; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D010880:Piperidines; D000077208:Remifentanil
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl