[Remifentanil provides fast recovery and hemodynamic stability in laryngomicrosurgery anesthesia].
BACKGROUND
Stressful procedures such as intratracheal intubation and direct laryngoscopy in very short operations make anesthetic management for laryngomicrosurgery difficult. This study was conducted to evaluate which anesthetic agent, remifentanil or fentanyl, is suitable in anesthesia for laryngomicrosurgery.


METHODS
After obtaining informed consent prior to the study, 18 patients undergoing elective laryngomicrosurgery were randomly allocated to one of two groups to receive remifentanil (R group) or fentanyl (F group). Patients with ages above 76 years and moderate abnormalities in cardiovascular system or respiratory system were excluded.


RESULTS
Average infusion rate of remifentanil was 0.24 +/- 0.02 microg x kg(-1) x min(-1) and total infused dose of fentanyl was 0.27 +/- 0.05 mg. Average bispectral index values in both groups were comparable. Cases needing sevoflurane inhalation to control blood pressure were significantly more in F group than in R group. Heart rate was significantly lower in R group than in F group. Duration from the end of operation to responses to verbal commands and extubation was significantly shorter in R group than in F group.


CONCLUSIONS
Remifentanil provided faster recovery and hemodynamic stability. Therefore, remifentanil seems to be more suitable than fentanyl in anesthesia for laryngomicrosurgery.
Kishi
Yoshihiko
Y
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511.
Tanigami
Hironobu
H
Kagawa
Kiyokazu
K
Asakura
Yoshimi
Y
Sonoda
Shunji
S
Hiuge
Yuki
Y
D018686:Anesthetics, Intravenous / Q000494:pharmacology; D005260:Female; D005283:Fentanyl / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl