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

J. Joseph Mackey, Stephen D. Parker, Caitlin M. Nass, Douglas S. Snyder, Shannon Curreri, Debra Kazim, Rhonda L. Zuckerman, Lee A. Fleisher

Research output: Contribution to journalArticle

Abstract

Study Objective: To determine if remifentanil would offer a superior hemodynamic and recovery profile compared to the current standard of care, which implements a fentanyl-based technique. Design: Randomized, single-blind study. Setting: Outpatient center associated with tertiary care center. Patients: 75 outpatients undergoing microsuspension laryngoscopy. Interventions: Patients were randomized to either a remifentanil induction (0.5 μg/kg/min) and maintenance (0.25 μg/kg/min) versus fentanyl (maximum of 250 μg) as the only opioid. All patients received propofol as part of the induction and maintenance with or without the use of nitrous oxide. Measurements: Assessment of hemodynamics [heart rate (HR) and blood pressure(BP)], presence of perioperative myocardial ischemia on ambulatory electrocardiographic monitoring, and time to discharge. Main Results: Significantly fewer patients in the remifentanil group demonstrated episodes of tachycardia (HR > 100 beats per min) compared to the fentanyl group (14% vs. 40%, p < 0.05), with significantly fewer episodes of tachycardia and hypertension per patient. Recovery profiles between the two groups did not show clinically significant differences. Conclusions: Remifentanil, a new short-acting opioid, offers excellent hemodynamic control for brief, intense outpatient procedures performed in high-risk patients; however, its use was not associated with any improvement in recovery profiles. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)427-432
Number of pages6
JournalJournal of Clinical Anesthesia
Volume12
Issue number6
DOIs
StatePublished - Nov 20 2000

Keywords

  • Hemodynamics
  • Intraoperative
  • Myocardial ischemia
  • Opioid
  • Postanesthesia care unit
  • Randomized clinical trial
  • Remifentanil

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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  • Cite this

    Mackey, J. J., Parker, S. D., Nass, C. M., Snyder, D. S., Curreri, S., Kazim, D., Zuckerman, R. L., & Fleisher, L. A. (2000). Effectiveness of Remifentanil versus traditional fentanyl-based anesthetic in high-risk outpatient surgery. Journal of Clinical Anesthesia, 12(6), 427-432. https://doi.org/10.1016/S0952-8180(00)00185-9