title: [Comparison of two opioids with different kinetics for intravenous analgesia in outpatient multiple third molar avulsions].
abstract: BACKGROUND
  We had for aim to compare the effects of intra-operative opioid analgesia according to the drug kinetics.
  
  
  METHODS
  We conducted a prospective, controlled, randomized, double-blinded trial including 60 patients scheduled for ambulatory multiple third molar avulsion. The general anesthesia, performed with propofol and analgesia was a target-controlled infusion of either remifentanil or sufentanil. The anesthesia was set to reach an optimal bispectral index and adjusted to a clinical target throughout the procedure. The main endpoints were: postoperative request for morphine and other opioids; postoperative pain; postoperative adverse effects of opioids.
  
  
  RESULTS
  In the post-operative care unit (French acronym PACU), patients who received remifentanil were extubated earlier (17 vs. 26 min.), but had more pain and required twice more morphine for analgesia (6 vs. 3 mg), than those who had received sufentanil. However, the need for post-surgery oral opioid intake was greater in the sufentanil group, so the overall postoperative opioid consumption and patient satisfaction were identical in both groups. The time spent in the PACU was also identical for both groups.
  
  
  CONCLUSIONS
  Using an ultra-short kinetic opioid such as remifentanil does not seem useful, since the shorter delay before extubation is compensated by a greater need for morphine in the PACU.
authors.affiliation: Pôle PRI, chirurgie maxillo-faciale, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Macario-Gérard
authors.affiliation: Pôle PRI, chirurgie maxillo-faciale, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Gonnu-Levallois
authors.affiliation: Pôle PRI, chirurgie maxillo-faciale, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Verny-Pic
authors.affiliation: Pôle odontologie et chirurgie maxillo-faciale, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; Pôle anesthésie-réanimation, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors.forename: I
authors.initials: I
authors.lastname: Barthélemy
authors.affiliation: Université Clermont 1, 63001 Clermont-Ferrand, France.
authors.forename: H
authors.initials: H
authors.lastname: Boby
authors.affiliation: Centre de pharmacologie clinique (CIC), hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, rue Montalembert, BP 69, 63003 Clermont-Ferrand cedex 1, France; Inserm, CIC 1405, U1107 « Neuro-Dol », 63003 Clermont-Ferrand, France. Electronic address: cduale@chu-clermontferrand.fr.
authors.forename: C
authors.initials: C
authors.lastname: Dualé
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010045:Outpatients; D010149:Postoperative Pain / Q000453:epidemiology; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000077208:Remifentanil; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D014084:Tooth Avulsion / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D017409:Sufentanil; D000077208:Remifentanil
keywords: Ambulatory surgical procedures; Anesthésie générale; Chirurgie ambulatoire; Dents de sagesse; General anesthesia; Wisdom teeth