[Fentanyl or remifentanil to potentiate a single dose of rocuronium in patients anesthetized with propofol with evaluation by accelerometry].
OBJECTIVE
To compare the increase in potency of a single dose of rocuronium during anesthesia with propofol combined with either fentanyl or remifentanil.


METHODS
Forty patients scheduled for plastic surgery were distributed in 2 groups of 20 according to the opioid drug assigned: fentanyl or remifentanil. Induction with propofol was accomplished by computer-controlled infusion, with response measured in the adductor pollicis muscle. After calibration, a dose of 0.6 mg/Kg of rocuronium was infused. Anesthesia was maintained with propofol, oxygen in air, and an equipotent dose of either fentanyl or remifentanil, which was modified to maintain heart rate and systolic arterial pressure within 30% above or below baseline levels. Patient characteristics recorded were age, sex, height, weight, ASA class, type of surgery, and the propofol and opioid doses consumed. Intubation conditions and time to onset of action of rocuronium (T1), of recovery of the first response in a train of four (RT1), and of recovery of 25% of the first response or clinical duration.


RESULTS
The groups were statistically similar in terms of demographic variables, type of surgery, propofol and opioid consumption, intubation conditions, and rocuronium T1 and RT1. Clinical duration of anesthesia was longer (p<0.05) in the remifentanil group (33.1 +/- 10 minutes) than in the fentanyl group (27.1 +/- 7.4 minutes).


CONCLUSIONS
Remifentanil administered in combination with propofol for anesthesia does not affect time of onset of a single dose of 0.6 mg/Kg dose of rocuronium, but clinical duration of anesthesia is longer with remifentanil and propofol than with the fentanyl and propofol combination. The surgical and intubation conditions achieved with both combinations are adequate and similar.
Ferreira
T A
TA
Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario Juan Canalejo, A Coruña.
Rama-Maceiras
P
P
Molins
N
N
Rey-Rilo
T
T
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004357:Drug Synergism; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil; D000077123:Rocuronium
D000759:Adjuvants, Anesthesia; D000732:Androstanols; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl; D000077123:Rocuronium; D015742:Propofol