The comparison of bispectral index guided propofol-remifentanil and propofol-fentanyl anesthesia on recovery, dreaming and postoperative analgesia requirements
Hüseyin Ulaş Pınar, Ömer Karaca, Rafi Doğan, Ümmü Mine Konuk
Department of Anesthesiyology, Baskent University, Konya, Turkey
Objective To investigate the comparative effects of Bispectral Index (BIS) guided remifentanil- propofol and fentanyl-propofol anesthesia on recovery, postoperative analgesia, and dreaming under the effect of anesthesia in brief outpatient gynecological procedures. Materials and Method One hundred and twenty-eight ASA I-II patients aged 18-60 years were randomized into 2 groups. The Group Remifentanil received 1 mcg/kg remifentanil bolus and the Group Fentanyl received 1 mcg/kg fentanyl in addition to 2 mg/kg propofol bolus for anesthesia induction. The additional doses of both medications were intermittently administered by BIS guidance during the operation. Postoperative time to eye opening, verbal response time, pain level, supplemental analgesia requirement, and intraoperative dreaming were recorded. Results The Group Remifentanil had a significantly shorter time to eye opening and verbal response time (p=0.01 and p<0.01, respectively). Postoperative pain level and analgesia requirement were greater in the Group Remifentanil (p<0.001 and p=0.005, respectively). Although the rate of intraoperative dreaming was higher in the Group Remifentanil (14/64 patients) compared to the Group Fentanyl (8/64 patients), this difference was not statistically significant (p> 0.05). Conclusions In conclusion, intermittent administration of BIS guided propofol-remifentanil is particularly a good option in brief outpatient gynecological procedures; however, it necessitates the use of an additional postoperative analgesic agent. The rate of dreaming under anesthesia was similar in remifentanil and fentanyl groups.
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