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A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions.

Publication ,  Journal Article
Balakrishnan, G; Raudzens, P; Samra, SK; Song, K; Boening, JA; Bosek, V; Jamerson, BD; Warner, DS
Published in: Anesth Analg
July 2000

UNLABELLED: We compared the effects of remifentanil versus fentanyl during surgery for intracranial space-occupying lesions. Patients were randomly assigned to receive either remifentanil (0.5 microg. kg(-1). min(-1) IV during the induction of anesthesia reduced to 0.25 microg. kg(-1). min(-1) after endotracheal intubation; n = 49) or fentanyl (dose per usual practice of the anesthesiologist; n = 54). Anesthesia maintenance doses of isoflurane, nitrous oxide, and opioid were at the anesthesiologist's discretion for both groups. There were no differences between opioid groups for the frequency of responses (hemodynamic, movement, and tearing) to intubation, pinhead holder placement, skin incision, or closure of the surgical wound. Adverse event frequencies were similar between groups. Times to follow verbal commands (P < 0.001) and tracheal extubation (P = 0. 04) were more rapid for remifentanil. The percentage of patients with a normal recovery score (were alert or arousable to quiet voice, were oriented, were able to follow commands, had motor function unchanged from their preoperative evaluation, were not agitated, and had modified Aldrete Scores of 9-10) at 10 min after surgery was more for remifentanil (45% vs 18%; P = 0.005). By 20 min, no difference between groups existed (P = 0.27). Anesthesiologists used more isoflurane in the fentanyl group (4.22 vs 1.93 minimum alveolar anesthetic concentration hours). Neurosurgeons, blinded to treatment group, favored the use of remifentanil. Similar frequencies of light anesthesia responses and other adverse events suggest that intraoperative depths of anesthesia were similar in the two groups. Under these conditions, emergence was more rapid with remifentanil. This is consistent with the necessity for less isoflurane use in the remifentanil group and the intrinsic rapid clearance of this opioid. IMPLICATIONS: Patients given remifentanil-based anesthesia for craniotomy had faster recovery times from anesthesia than did those given fentanyl-based anesthesia.

Duke Scholars

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

July 2000

Volume

91

Issue

1

Start / End Page

163 / 169

Location

United States

Related Subject Headings

  • Remifentanil
  • Prospective Studies
  • Piperidines
  • Middle Aged
  • Male
  • Humans
  • Hemodynamics
  • Fentanyl
  • Female
  • Brain Diseases
 

Citation

APA
Chicago
ICMJE
MLA
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Balakrishnan, G., Raudzens, P., Samra, S. K., Song, K., Boening, J. A., Bosek, V., … Warner, D. S. (2000). A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions. Anesth Analg, 91(1), 163–169. https://doi.org/10.1097/00000539-200007000-00030
Balakrishnan, G., P. Raudzens, S. K. Samra, K. Song, J. A. Boening, V. Bosek, B. D. Jamerson, and D. S. Warner. “A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions.Anesth Analg 91, no. 1 (July 2000): 163–69. https://doi.org/10.1097/00000539-200007000-00030.
Balakrishnan G, Raudzens P, Samra SK, Song K, Boening JA, Bosek V, et al. A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions. Anesth Analg. 2000 Jul;91(1):163–9.
Balakrishnan, G., et al. “A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions.Anesth Analg, vol. 91, no. 1, July 2000, pp. 163–69. Pubmed, doi:10.1097/00000539-200007000-00030.
Balakrishnan G, Raudzens P, Samra SK, Song K, Boening JA, Bosek V, Jamerson BD, Warner DS. A comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions. Anesth Analg. 2000 Jul;91(1):163–169.

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

July 2000

Volume

91

Issue

1

Start / End Page

163 / 169

Location

United States

Related Subject Headings

  • Remifentanil
  • Prospective Studies
  • Piperidines
  • Middle Aged
  • Male
  • Humans
  • Hemodynamics
  • Fentanyl
  • Female
  • Brain Diseases