[Remifentanil for intraoperative anesthesia].
OBJECTIVE
To compare the efficacy and safety of remifentanil with fentanyl used for intraoperative anesthesia.


METHODS
Fifty-four patients undergoing modified radical mastectomy or total hysterectomy were randomly assigned to remifentanil group or fentanyl group with 27 cases in each group. Anesthesia was induced with propofol (2 mg/kg) and either remifentanil (2 micrograms/kg) or fentanyl (2.5 micrograms/kg), and was maintained with inhalation of nitrous oxide in oxygen (2:1) and a continuous infusion of either remifentanil (0.2 microgram.kg-1.min-1) or fentanyl (0.03 microgram.kg-1.min-1). Depth of anesthesia, hemodynamic changes, recovery profile of anesthesia, postoperative analgesia and adverse reactions were observed.


RESULTS
The number of patients exhibited light depth of anesthesia during tracheal intubation and maintenance in the remifentanil group was significantly fewer than that in the fentanyl group (P < 0.05). Hemodynamic changes during intubation, skin incision, maintenance of anesthesia and extubation in the remifentanil group were significantly smaller than those in the fentanyl group (P < 0.05, P < 0.01). The time to opening eyes on command and the time for extubation after surgery were comparable between the two groups. More patients in the remifentanil group required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (P < 0.05). There was no significant difference between the two groups in the aspect of adverse reactions.


CONCLUSIONS
The anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability compared with fentanyl without compromising recovery from anesthesia.
Guo
Xiang-yang
XY
Department of Anaesthesia, PUMC Hospital, CAMS and PUMC, Beijing 100730, China. xyg34@hotmail.com
Yi
Jie
J
Yie
Tie-hu
TH
Luo
Ai-lun
AL
Ren
Hong-zhi
HZ
Huang
Yu-guang
YG
D000293:Adolescent; D000328:Adult; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007044:Hysterectomy; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl