The effects of remifentanil and sufentanil on the quality of recovery after day case laparoscopic cholecystectomy: a randomized blinded trial.
BACKGROUND
Duration of hospitalization after laparoscopic cholecystectomy (LC) is mainly determined by temporary side effects such as pain, nausea, and vomiting. In this study we compared remifentanil, a short acting opioid, and sufentanil, a longer acting opioid, on their ability to reduce these postoperative effects and facilitate LC in day case surgery.


METHODS
Seventy patients scheduled for elective LC were randomized in two groups. Remifentanil was used in group 1 as part of the anesthetic protocol, sufentanil was used in group 2. After surgery, patients were asked to evaluate pain and nausea on a verbal rate scale (VRS). Frequency of vomiting and analgesic medication consumption was registered. Time between surgery and to the start of micturition, drinking, mobilization, dressing, and discharge was recorded. Patients registered their satisfaction on a VRS. Details of any other adverse events throughout the study were recorded.


RESULTS
Twenty-two patients (63%) of group 1 were treated as day cases vs. 27 (77%) in group 2 (P = NS). All patients who were not discharged as day cases left the hospital one day postoperatively. Immediately after surgery, patients in group 2 reported significantly less pain. There were no other significant differences between groups.


CONCLUSIONS
The majority of patients scheduled for LC can be safely discharged on the day of surgery. Reported satisfaction one week postoperatively was high for all patients. We found no major relevant differences between the two anesthetic protocols.
Damen
S L
SL
Department of Surgery, Diakonessenhuis, Utrecht, Netherlands. s.damen@wanadoo.nl
Nieuwenhuijs
V B
VB
Joosten
W
W
Houweling
P L
PL
Clevers
G J
GJ
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D017409:Sufentanil / Q000627:therapeutic use*; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D010880:Piperidines; D017409:Sufentanil; D000077208:Remifentanil