Effects of fentanyl on emergence characteristics from anesthesia in adult cervical spine surgery: a comparison of fentanyl-based and sevoflurane-based anesthesia.
OBJECTIVE
To evaluate the effects of different anesthesia regimens on bucking, awareness, and pain during the emergence from anesthesia, which may affect neck stabilization and neurological assessment immediately after cervical spine surgery.


METHODS
Patients scheduled to undergo cervical spine surgery were assigned randomly into one of three groups: maintenance of anesthesia with fentanyl and propofol TCI (group FP, n = 25); maintenance with fentanyl and supplementation with less than 1% sevoflurane (group Fs, n = 25); and maintenance solely with sevoflurane (group S, n = 25). The severity of bucking, extent of awareness during neurological examination, and perception of pain during the emergence phase were assessed using predetermined scoring scales by a nurse blinded to the method of anesthesia.


RESULTS
The bucking score and pain score were significantly better in group FP and group Fs than in the group S, whereas there was no significant difference between the data of group FP and group Fs.


CONCLUSIONS
The quality of emergence from anesthesia in patients with cervical spine surgery is improved with fentanyl-based anesthesia, but there is no difference between the use of propofol TCI and less than 1% sevoflurane as a concomitant sedative agent with fentanyl.
Inoue
Yoshitaka
Y
Department of Anesthesia, Labor Health and Welfare Organization, Spinal Injuries Center, 550-4 Igisu, Iizuka, 820-8508, Japan.
Koga
Kazunori
K
Sata
Takeyoshi
T
Shigematsu
Akio
A
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002574:Cervical Vertebrae; D005260:Female; D005283:Fentanyl; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011184:Postoperative Period; D015742:Propofol; D011446:Prospective Studies; D000077149:Sevoflurane; D013131:Spine / Q000601:surgery*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D005283:Fentanyl; D015742:Propofol