title: Effect of remifentanil on the hemodynamic responses and recovery profile of patients undergoing single jaw orthognathic surgery.
abstract: The aim of this study was to compare fentanyl-based versus remifentanil-based anesthesia with regards to the intraoperative hemodynamic stress response and recovery profiles in patients undergoing Le Fort I osteotomy. Seventeen patients were randomly divided into two groups: patients in the F-group received 2 μg/kg fentanyl intravenously followed by an infusion of 0.03-0.06 μg/kg/min, while patients in the R-group received a 0.5 μg/kg bolus of remifentanil followed by an infusion of 0.0625-0.250 μg/kg/min. Mean arterial pressure and heart rate were recorded at the following points: before anesthetic induction, at endotracheal intubation, 5 min after intubation, at incision, just before the osteotomy, during the osteotomy, during the maxillary fracturing, at suturing, at extubation, 5 min after extubation, and then 15 and 30 min postoperatively. Heart rate and mean arterial pressure were significantly lower in the R-group in comparison to the F-group from t1 to t9 (P<0.05). All measured recovery times were significantly shorter in the R-group (P<0.05). The incidence of postoperative side effects was comparable between groups. Remifentanil-based anesthesia is an appropriate alternative to fentanyl during Le Fort I orthognathic surgery; it promotes hemodynamic stability, blunts the stress response to noxious stimuli, and provides a better recovery profile.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dental College, King Saud University, Riyadh, Saudi Arabia. nassernoohomfs@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Nooh
authors.forename: A A
authors.initials: AA
authors.lastname: Abdelhalim
authors.forename: W A
authors.initials: WA
authors.lastname: Abdullah
authors.forename: S A
authors.initials: SA
authors.lastname: Sheta
mesh_terms: D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D062186:Arterial Pressure / Q000187:drug effects*; D016063:Blood Loss, Surgical; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D007741:Labetalol / Q000627:therapeutic use; D008297:Male; D008437:Maxilla / Q000601:surgery; D008738:Methyl Ethers / Q000008:administration & dosage; D016343:Monitoring, Intraoperative; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology; D010880:Piperidines / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane; D016037:Single-Blind Method; D058106:Wound Closure Techniques; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000959:Antihypertensive Agents; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D007741:Labetalol; D005283:Fentanyl