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Original ArticleOpen Access
A Multicenter Randomized Double-Blind Comparison of Remifentanil and Alfentanil During Total Intravenous Anaesthesia for Out-Patient Laparoscopic Gynaecological Procedures
Clrinachoti T 
,
Werawatgano11 T ,
Suksompong S ,
Techanivate A ,
Kitsampanwong W ,
Tansui R ,
Srivajana N ,
Silapadech A ,
Chainchop P ,
Noocharoen P ,
Chansennkit R ,
Clratkitcharoen N ,
Chaiyakul A ,
Nursing Di ,
Suwatcharaphan P
,
Werawatgano11 T ,
Suksompong S ,
Techanivate A ,
Kitsampanwong W ,
Tansui R ,
Srivajana N ,
Silapadech A ,
Chainchop P ,
Noocharoen P ,
Chansennkit R ,
Clratkitcharoen N ,
Chaiyakul A ,
Nursing Di ,
Suwatcharaphan P THEWARUG WERAWATGANON,M.D.**,
ANCHALEE TECHANIVATE,M.D.**,
RASSANEE TANSUI, M.D.*,
AURASA SILAPADECH, B.N.*,
PENSRI NOOCHAROEN, B.N.*,
NATTAYA CHATKITCHAROEN,M.D.**,
ANONG CHAIY AKUL, Diploma in Nursing****,
We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part of the
total intravenous anesthesia with propofol and atracurium for out-patient laparoscopic gynaeco-
logical procedures in a multicenter randomized, double-blind study. We chose Remifentanil I
mg./kg.for bolus injection and a continuous infusion of 0.25-0.5 jlg./kg./min, compared to Alfen-
tanil 20 11g./kg. For bolus injection and a continuous infusion of 0.5-1 jlg./kg./min. Fifty-nine
patients received Remifentanil, and sixty-three received Alfentanil. Patients who received Remi-
fetanil experienced significantly fewer stress responses to surgical stimuli (p
<
0.05) and required
fewer additional boluses of study drugs and propofol (p
<
0.05) than Alfentanil during the intra-
operative period. Response time to verbal commands, spontaneous respiration, adequate respira-
tion and tracheal extubation, were not significantly different between these two opioids. Remifen-
tanil patients, required more fentanyl for post operative pain control, 40 from 59 cases in the Remifen-
tanil group and 22 from 63 cases in theเธ— Alfentanil group (p
<
0.05) but still showed significantly
better recovery of psychomotor function by Aldrete score of ten at 50 and 60 min (p
<
0.05) than
Alfentanil patients. The incidence of intraoperative bradycardia was significantly higher with
Remifentanil. Other incidences of nausea, emesis, urinary retention and postural hypotension were
similar. All patients were ready to be discharged from the hospital within two hours after extuba-
tion except for one patient in the Alfentanil group who needed five hours of hospital stay because
of urinary retention, nausea and severe emesis.
Key word: Remifentanil, Total Intravenous Anaesthesia, Out-Patient
ANCHALEE TECHANIVATE,M.D.**,
RASSANEE TANSUI, M.D.*,
AURASA SILAPADECH, B.N.*,
PENSRI NOOCHAROEN, B.N.*,
NATTAYA CHATKITCHAROEN,M.D.**,
ANONG CHAIY AKUL, Diploma in Nursing****,
We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part of the
total intravenous anesthesia with propofol and atracurium for out-patient laparoscopic gynaeco-
logical procedures in a multicenter randomized, double-blind study. We chose Remifentanil I
mg./kg.for bolus injection and a continuous infusion of 0.25-0.5 jlg./kg./min, compared to Alfen-
tanil 20 11g./kg. For bolus injection and a continuous infusion of 0.5-1 jlg./kg./min. Fifty-nine
patients received Remifentanil, and sixty-three received Alfentanil. Patients who received Remi-
fetanil experienced significantly fewer stress responses to surgical stimuli (p
<
0.05) and required
fewer additional boluses of study drugs and propofol (p
<
0.05) than Alfentanil during the intra-
operative period. Response time to verbal commands, spontaneous respiration, adequate respira-
tion and tracheal extubation, were not significantly different between these two opioids. Remifen-
tanil patients, required more fentanyl for post operative pain control, 40 from 59 cases in the Remifen-
tanil group and 22 from 63 cases in theเธ— Alfentanil group (p
<
0.05) but still showed significantly
better recovery of psychomotor function by Aldrete score of ten at 50 and 60 min (p
<
0.05) than
Alfentanil patients. The incidence of intraoperative bradycardia was significantly higher with
Remifentanil. Other incidences of nausea, emesis, urinary retention and postural hypotension were
similar. All patients were ready to be discharged from the hospital within two hours after extuba-
tion except for one patient in the Alfentanil group who needed five hours of hospital stay because
of urinary retention, nausea and severe emesis.
Key word: Remifentanil, Total Intravenous Anaesthesia, Out-Patient
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