Intravenous anesthesia


Anesthesia and Pain Medicine. 2006 Mar. 10(1): 17-22
ⓒ Korean Society for Intravenous Anesthesia
Comparison of Alfentanil and Remifentanil for Analgesic Effect during Stab Avulsion for Varicose Vein of Lower Extremities under the Monitored Anesthesia Care
Haeng Seon Shim, M.D., Soon Hee Park, M.D., and Myoung Keun Shin, M.D.
Department of Anesthesiology and Pain Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea

Background: We used alfentanil for analgesic effect during stab avulsion for varicose vein of lower extremities. We prefer to use alfentanil in outpatient anesthesia because alfentanil represent short context-sensitive halftime and rapid onset than fentanyl. But patients sometimes complain discomfort and pain during especially unexpected long time operation because of relatively low potency of alfentanil. However remifentanil is recently introduced opioid represents very short context-sensitive halftime, rapid onset and more potent than alfentanil. In order to get better analgesic effect, we compared remifentanil with alfentanil. Methods: Forty adults (ASA I, II) undergoing stab avulsion for varicose vein of lower extremities were randomly assigned to two groups (RF and AF group). Intravenous remifentanil was given to RF group, 0.5μg/kg loading dose and 0.05μg/kg/min continuous dose. Intravenous alfentanil was given to AF group, 2.5μg/kg loading dose and 0.25μg/kg/min. Heart rate (HR), blood pressure (BP), visual analogue scale (VAS) score, postanesthetic discharge score, adverse effect, postoperative satisfaction score were recorded. Results: VAS score was lower in RF group than AF group during wound traction and electric cautery (P < 0.05). Postoperative satisfaction score was better in RF group than AF group (P < 0.05). But bradycardia developed more frequent in RF group than AF group (P < 0.05). Conclusions: We suggest that remifentanil offered better analgesic effect than alfentanil, but we need to investigate an optimal dose of remifentanil.
Key words : alfentanil, postoperaive satisfaction score, remifentanil, VAS score
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