Recovery of psychomotor function after total intravenous anesthesia with remifentanil–propofol or fentanyl–propofol

Takayama, Aki; Yamaguchi, Shigeki; Ishikawa, Kazuyoshi; Shinozaki, Masataka; Kimura, Yoshiyuki; Nagao, Masaru; Kitajima, Toshimitsu

doi:10.1007/s00540-011-1266-5

Cited by 11 publications

(14 citation statements)

References 25 publications

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“…These differences might be mainly attributed to the use of fentanyl for analgesia in the study by Magni et al 15 ; in contrast, we selected an ultra-shortacting opioid, remifentanyl, and our patients also had a younger mean age (by 15 years). Although an analysis of early cognitive functions by Magni et al 15 found no differences in recovery functions between patients who received sevoflurane-fentanyl and propofol-remifentanil combinations while undergoing craniotomy for supratentorial intracranial surgery, the findings of many other studies agreed with our finding that anaesthesia with remifentanyl infusion provides an early recovery 16,17 . Kaye et al 13 compared desflurane and isoflurane in the context of neurosurgery and achieved 50% decrease in early recovery and eye opening times in the desflurane group.…”

Section: Discussionsupporting

confidence: 88%

Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

et al. 2016

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PURPOSE:To compared the effects of sevoflurane and desflurane on early anesthesia recovery in patients undergoing to craniotomy for intracranial lesions. METHODS:After IRB approval, the study included 50 patients aged 18-70 years who had ASA physical statuses of I-II and were scheduled for intracranial surgery. Patients were randomly divided into two groups: sevoflurane and desflurane. Anaesthesia was routinely induced in all patients followed by desflurane 5%-6% or sevoflurane 1%-2%. Moreover remifentanil infusion (0.05-0.2 mcg/ kg/min) was adjusted to maintain mean arterial pressure (MAP) within 20% baseline and heart rate <90 bpm. Postoperatively, patients were evaluated over time for responses to painful stimulus, eye opening, hand squeezing, extubation, orientation and time required to achieve a Modified Aldrete Score of 9-10. Parametric and non-parametric data were assessed using Student's t-and Mann-Whitney U tests, respectively. A p<0.05 was taken as statistically significant. RESULTS:The times to responses to painful stimuli (7.7±2.7 vs. 4.8±1.7 min.; p<0.001), emergence (9.5±2.81 vs. 6.3±2.2 min.; Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

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Section: Discussionsupporting

confidence: 88%

Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

et al. 2016

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“…The context-sensitive half-life of remifentanil is extremely less than fentanyl [18] . The recovery of psychomotor function after total intravenous anesthesia (TIVA) with remifentanil, which does not use any inhalational agents, was 30–120 min faster than TIVA with fentanyl [19] . Orthognathic patients who were maintained with TIVA with remifentanil had significantly higher pain scores within the first 4 h postoperatively [20] .…”

Section: Discussionmentioning

confidence: 99%

Factors that Affect Intravenous Patient-Controlled Analgesia for Postoperative Pain Following Orthognathic Surgery for Mandibular Prognathism

et al. 2014

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The predictors of postoperative pain and analgesic consumption were previously found to include preoperative pain, anxiety, age, type of surgery, and genotype, but remaining unclear was whether intraoperative factors could predict postoperative pain. In the present study, we investigated the time-course of fentanyl consumption using intravenous patient-controlled analgesia records from patients who underwent orthognathic surgery for mandibular prognathism and analyzed the influence of anesthesia methods and surgical methods together with sex on the time course. A significant difference in the time course of fentanyl administration was found (P<0.001). No significant difference in the time course of fentanyl administration was found between males and females (P = 0.653), with no interaction between time course and sex (P = 0.567). No significant difference in the time course of fentanyl administration was found among anesthesia methods, such as fentanyl induction followed by fentanyl maintenance, fentanyl induction followed by remifentanil maintenance, and remifentanil induction followed by remifentanil maintenance (P = 0.512), but an interaction between time course and anesthesia method was observed (P = 0.004). A significant difference in the time course of fentanyl administration was found between surgical methods, such as bilateral mandibular sagittal split ramus osteotomy (BSSRO) and BSSRO combined with Le Fort I osteotomy (bimaxillary; P = 0.008), with no interaction between time course and surgical method (P = 0.535). Total postoperative 24 h consumption associated with the bimaxillary procedure was significantly higher than with BSSRO (P = 0.008). The present results indicate that administration patterns and total 24 h consumption were different among the three groups of anesthesia methods and between the two groups of surgical methods, respectively. Although more research on patient-controlled analgesia patterns and consumption is necessary, the present study will contribute to adequately relieving individual patients from postoperative pain.

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“…A total of 2879 articles were obtained, of which 14 studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23] were found eligible to be included in the systematic review (Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

Comparison of Fentanyl, Remifentanil, Sufentanil and Alfentanil in Combination with Propofol for General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Sridharan

Sivaramakrishnan

2019

CCP

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Background: Opioid analgesics are commonly used along with propofol during general anesthesia. Due to the dearth of data on the quality of anesthesia achieved with this combination, the present meta-analysis was carried out. Methods: Electronic databases were searched for appropriate studies using a suitable search strategy. Randomized clinical trials comparing the combination of remifentanil/sufentanil/alfentanil with propofol with fentanyl and propofol, were included. The outcome measures were as follows: total propofol dose to achieve the desired general anesthesia; time of onset and duration of general anesthesia; depth of general anesthesia; and recovery time (time for eye-opening and time taken for extubation). Risk of bias was assessed and Forest plots were generated for eligible outcomes. The weighted mean difference [95% confidence intervals] was used as the effect estimate. Results: Fourteen studies were included in the systematic review and 13 were included in the metaanalysis. Statistically significant differences were observed for remifentanil in comparison to fentanyl when combined with propofol: Propofol dose (in mg) -76.18 [-94.72, -57.64]; time of onset of anesthesia (min) -0.44 [-0.74, -0.15]; time taken for eye-opening (min) -3.95 [-4.8, -3.1]; and time for extubation (min) -3.53 [-4.37, -2.7]. No significant differences were observed for either sufentanil or alfentanil about the dose of propofol required and due to scanty data, pooling of the data could not be attempted for other outcome measures for either sufentanil or alfentanil. Conclusion: To conclude, we found that remifentanil has a statistically significant anesthetic profile than fentanyl when combined with propofol. Scanty evidence for both alfentanil and sufentanil precludes any such confirmation.

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Recovery of psychomotor function after total intravenous anesthesia with remifentanil–propofol or fentanyl–propofol

Abstract: Recovery of psychomotor function in TIVA with remifentanil-propofol is faster than that in TIVA with fentanyl-propofol.

Cited by 11 publications

References 25 publications

Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

Early postoperative recovery after intracranial surgical procedures. Comparison of the effects of sevoflurane and desflurane

Factors that Affect Intravenous Patient-Controlled Analgesia for Postoperative Pain Following Orthognathic Surgery for Mandibular Prognathism

Comparison of Fentanyl, Remifentanil, Sufentanil and Alfentanil in Combination with Propofol for General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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