Effectiveness of Remifentanil versus traditional fentanyl-based anesthetic in high-risk outpatient surgery

Remifentanil na prática clínica

“…In laryngeal microsurgeries and associated to propofol, 79% of patients have reached Aldrete's score 9 or 10, already 10 minutes after surgery completion, as compared to 40% after fentanyl, and this difference has persisted even after 30 minutes (95% versus 65%) 112 . In a different study with this same procedure, associated to propofol and compared to fentanyl, there has been lower incidence of tachycardia, arterial hypertension, lower propofol consumption, but higher incidence of bradycardia 113 .…”

“…Para microcirurgia de laringe, associado ao propofol, 79% dos pacientes atingiram índice de Aldrete 9 ou 10 até 10 minutos após o fim da cirurgia, comparado a 40% após o uso de alfentanil, e essa diferença persistiu mesmo após 30 minutos (95% versus 65%) 112 . Em outro estudo com esse mesmo procedimento cirúrgico, associado ao propofol e comparado ao fentanil, houve menor incidência de taquicardia, hipertensão arterial, menor consumo de propofol mas maior incidência de bradicardia 113 .…”

Remifentanil versus fentanyl compared in a target-controlled infusion of propofol anesthesia: quality of anesthesia and recovery profile

“…Remifentanil may be useful in ear-nose-throat surgery because of its ultrashort duration of action, allowing a more predictable emergence and recovery. The clinical advantages of remifentanil such as the rapid onset and offset with a context-sensitive half-time of only 3-5 min irrespective of the duration of infusion would make it difficult to compare with those of longer-acting opioids such as fentanyl [2,[6][7][8]. Furthermore, remifentanil is the most preferred opioid for use in conjunction with propofol-based TCI anesthesia, but in the present study, the standard regimen of fentanyl infusion at the given doses demonstrated comparable clinical features with the standard regimen of remifentanil.…”

Anaesthesia for carotid endarterectomy: comparison of hypnotic- and opioid-based techniques †

“…These observations con®rm the results of many other studies on more restricted populations. Mackey and colleagues 15 showed that on laryngoscopy, a situation during which high-risk patients undergo brief but very high levels of re¯ex-generating stimulation, fewer episodes of tachycardia and hypertension occurred using remifentanil compared with fentanyl. Prakash and colleagues 16 also found attenuated haemodynamic responses to rigid bronchoscopy using remifentanil compared with fentanyl.…”