A comparison of remifentanil and fentanyl in patients undergoing carotid endarterectomy

Abstract

Remifentanil appears to be a comparable opioid to fentanyl when supplementing isoflurane/nitrous oxide anaesthesia for carotid endarterectomy.

Recovery and cognitive function after fentanyl or remifentanil administration for carotid endarterectomy

“…This observation is in accord with the results of previous investigations after carotid artery operations [5,6]. In evaluating patient recovery using the Aldrete scale 15 and 60 minutes after the end of surgery, no differences were noted between the 2 groups.…”

“…The dose regimen for remifentanil in the present study is higher than the regimen used by previous investigators in carotid artery surgery [5,6], but it has been effectively administered by other authors [18,19]. It was chosen to investigate remifentanil's ability to reduce intraoperative hypertensive events.…”

“…Remifentanil is a l-opioid receptor agonist that has potency similar to that of fentanyl and systemic half-life approximately 9 to 11 minutes, which allows rapid emergence from anesthesia even after prolonged infusions [1][2][3]. However, it is not clear whether remifentanil is superior to fentanyl as far as intraoperative hemodynamic stability and recovery characteristics after carotid endarterectomy are concerned [4][5][6].…”

Remifentanil and Other Opioids

“…with a regional technique). Clinically, remifentanil titratability translates into a better control over adrenergic stimuli whatever the type of surgery or the patients (Kapila et al 1995;Mouren et al 2001;Schuttler et al 1997;Cartwright et al 1997;Gemma et al 2002;Guy et al 1997;Howie et al 2001;McGregor et al 1998;Sneyd et al 2001;Ahonen et al 2000;Balakrishnan et al 2000;Casati et al 2000;Doyle et al 2001;Fleisher et al 2001;Natalini et al 1999;Twersky et al 2001;Wee et al 1999;Wilhelm et al 2001). For example, intubation is a stronger stimulus than laryngoscopy, which in turn is stronger than skin incision.…”

Anästhesie zur Karotischirurgie

“…Am schnellsten ist die neurologische Beurteilbarkeit nach Remifentanil zu erreichen. In Bezug auf hämo-dynamische Stabilität oder postoperative Übelkeit zeigten sich keine Unterschiede zwischen Fentanyl, Sufentanil und Remifentanil [24,62]. De Castro et al [22] untersuchten die Hämodynamik in Abhängigkeit von der Art der Remifentanilapplikation.…”