Remifentanil versus alfentanil in total intravenous anaesthesia for day case surgery.
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 microg kg(-1) followed by 2 microg kg(-1) min(-1) intravenously; patients in Group 2 (n = 20) received remifentanil 1 microg kg(-1) followed by 0.5 microg 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 > or = 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 > or = 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.
Alper
I
I
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bornova, Izmir, Turkey. elvanerhan@yahoo.com
Erhan
E
E
Ugur
G
G
Ozyar
B
B
D000293:Adolescent; D000328:Adult; D015760:Alfentanil; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D010880:Piperidines; D000077208:Remifentanil; D014646:Varicocele / Q000601:surgery
D018686:Anesthetics, Intravenous; D010880:Piperidines; D015760:Alfentanil; D000077208:Remifentanil