Remifentanil versus fentanyl compared in a target-controlled infusion of propofol anesthesia: quality of anesthesia and recovery profile.
OBJECTIVE
The aim of the present study was to compare the clinical properties of fentanyl versus remifentanil in a target-controlled infusion (TCI) of propofol anesthesia regimen with bispectral index (BIS) monitoring.


METHODS
Forty consenting patients scheduled for elective septorhinoplasty were prospectively studied as one of two groups: fentanyl (group F) or remifentanil (group R). After loading boluses of fentanyl 3 microg kg(-1) or remifentanil 1 microg kg(-1) were administered, the continuous infusion of fentanyl or remifentanil was started at a rate of 0.03 or 0.15 microg kg(-1) min(-1), respectively. Propofol infusion was then commenced with a 3 microg ml(-1) effect site concentration (Ce) by means of a TCI device. The Ce propofol was adjusted to keep BIS at 50 +/- 10.


RESULTS
The general mean value of propofol Ce for group F and group R was 4.0 and 3.5 microg ml(-1), respectively. As to the recovery profile, the eye opening time (mean, 6.7 vs. 4.6 min), extubation time (mean, 7.3 vs. 4.7 min), and orientation time (mean, 7.6 vs. 4.9 min) were found to be significantly longer in group F than in group R.


CONCLUSIONS
We concluded that in propofol-based TCI anesthesia under BIS supervision for septorhinoplasty operations, remifentanil was better than fentanyl, especially with respect to emergence from total intravenous anesthesia (TIVA). Furthermore, the durations of anesthesia and operation were rather short, which indicates that fentanyl can be safely used.
Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, 06500 Ankara, Turkey. dcoskun@gazi.edu.tr
Demet
D
Coskun
Hulya
H
Celebi
Gozde
G
Karaca
Lale
L
Karabiyik
D000328:Adult; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D005283:Fentanyl; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D013517:Otorhinolaryngologic Surgical Procedures; D010880:Piperidines; D015742:Propofol; D011997:Recovery Room; D000077208:Remifentanil; D055815:Young Adult
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl; D015742:Propofol