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[A comparison of remifentanil versus sufentanil with target-controlled infusion in combined inhalation anesthesia for surgical patients: effects on hemodynamics and postoperative recovery].

OBJECTIVE
To compare the effect of remifentanil versus sufentanil with target-controlled infusion in combination with inhalation anesthesia for surgical patients on the parameters of hemodynamics and postoperative recovery.


METHODS
Forty ASA I-II patients aged 18 - 65 years old with BMI (body mass index) < 30, undergoing colectomy or pedical screw interfix were enrolled. Upon the approval of institutional Ethics Committee, they were randomized to receive remifentanil or sufentanil at a target plasma concentration of 3 ng/ml and 0.3 ng/ml respectively in combination of inhalated anesthesia at 0.9 MAC (minimal alveolar concentration). The infusion of remifentanil was discontinued at the end of surgery while the infusion of sufentanil at 40 - 60 minutes before the end of surgery. The arterial blood pressure (ABP), heart rate (HR), electrocardiogram (ECG) and pulse blood oxygen saturation during anesthesia were monitored. The time between the termination of anesthetic use and recovery of spontaneous breathing and extubation were observed. And the incidence of postoperative pain and respiratory depression were recorded.


RESULTS
As compared with the baseline values, BP and HR decreased significantly in both groups. BP was similar in both groups whereas HR was lower in Group R than that in Group S at post-induction, post-intubation, incision, the end of surgery and extubation (P < 0.05). The time from termination of anesthesia to recovery of spontaneous breathing was 1.8 ± 1.4 min in Group R. And it was significantly shorter than that in Group S (2.9 ± 1.5 min) (P < 0.05). The time from termination of anesthetic use to extubation was 6.8 ± 3.9 min in Group R. And it was also significantly shorter than that in Group S (9.1 ± 2.8 min) (P < 0.05). Seven patients experienced postoperative pain with visual analogue scale (VAS) > 4. And morphine was used for rescue analgesia in recovery room.


CONCLUSION
When combined with inhalation anesthesia, the effects on hemodynamics are similar between the patients receiving the target-controlled infusions of remifentanil and sufentanil. Remifentanil offers a shorter time to recovery of spontaneous breathing and tracheal extubation.