Comparison of hemodynamics recovery profile and costs of remifentanil versus fentanyl-based sevoflurane anesthesia.

Objective: This trial was designed to compare the effects of fentanyl and remifentanil on hemodynamic parameters, postoperative recovery, sevoflurane consumption and the cost of anesthetics. Material and Methods: Cases that were scheduled to undergo elective laparoscopic cholecystectomy surgery were...

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Published in:Turkiye Klinikleri Journal of Medical Sciences Vol. 32; no. 3; pp. 707 - 715
Main Authors: Uluer, Mehmet Selçuk, Topal, Ahmet, Tavlan, Aybars, Erol, Atilla, Kiliçaslan, Alper, Otelcioglu, Seref
Format: clinical trial research tables/charts Journal Article
Published: Turkiye Klinikleri Jun2012
Online Access:View this record in EBSCOhost
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      dt: Jun2012
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        atl: Comparison of hemodynamics recovery profile and costs of remifentanil versus fentanyl-based sevoflurane anesthesia.
      aug:
        au:
          Uluer, Mehmet Selçuk
          Topal, Ahmet
          Tavlan, Aybars
          Erol, Atilla
          Kiliçaslan, Alper
          Otelcioglu, Seref
      sug:
        subj:
          Anesthesia Methods
          Costs and Cost Analysis
          Fentanyl
          Hemodynamics
          Recovery
          Sevoflurane
          Adult
          Aged
          Arterial Pressure
          Chi Square Test
          Cholecystectomy
          Clinical Trials
          Goodness of Fit Chi Square Test
          Human
          Laparoscopy
          Mann-Whitney U Test
          Middle Age
          Post Hoc Analysis
          Random Sample
          Surgery, Elective
          T-Tests
          Two-Way Analysis of Variance
          Visual Analog Scaling
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
      ab: Objective: This trial was designed to compare the effects of fentanyl and remifentanil on hemodynamic parameters, postoperative recovery, sevoflurane consumption and the cost of anesthetics. Material and Methods: Cases that were scheduled to undergo elective laparoscopic cholecystectomy surgery were assigned to two groups with simple random sampling method, as Group F (Fentanyl) and Group R (Remifentanil), each including 30 patients. The anesthetic induction was initiated by administering 1-2 mg/kg propofol bolus based on the bispectral index (BIS) value followed by 2 µg/kg fentanyl in Group F patients and 1 µg/kg remifentanil in Group R patients administered in 60 seconds as iv bolus; subsequently, 0.5 mg/kg iv atracurium was administered. For maintenance of anesthesia, 50% oxygen in-air was administered at 4 L/min; the end-tidal sevoflurane concentration was adjusted to achieve a BIS value of 45 to 55. In Group R, remifentanil 0.25 µg/kg/min infusion was continued. The addition of 0.5 µg/kg fentanyl was planned as required in Group F. Sevoflurane end-tidal concentration and the changing times were recorded. For each case, the sevoflurane consumption was calculated using the Dion formula. Results: In Group R, the hemodynamic control, particularly the suppression of response to intubation was more successful than in Group F. The eye opening times and Post Anesthesia Care Unit (PACU) transfer times were shorter in Group R relative to Group F (p=0.001 and p=0.001, respectively). Sevoflurane consumption was lower in the Group R (7.18±3.45 mL) compared to Group F (16.45±7.15 mL) (p=0.001). The total anesthetic drug cost was similar between the groups. Conclusion: Compared to fentanyl, remifentanil provided a better intraoperative hemodynamic control, faster postoperative recovery and a favorable effect on anesthetic drug cost by decreasing sevoflurane consumption, eliminating the disadvantages of its price.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: Turkish
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