Comparative analysis of the effectiveness of Remifentanil versus Fentanyl anesthesia applied in urological laparoscopic surgery / 中华老年医学杂志

ABSTRACT

Objective To compare the effectiveness of Remifentanil versus Fentanyl anesthesia applied in urological laparoscopic surgery. Methods A total of 78 patients undergoing urologic endoscopy in our hospital from July 2016 to December 2017 were recruited ,and randomly divided into the Remifentanil group(n= 39)with Remifentanil anesthesia and the Fentanyl group(n= 39)with Fentanyl anesthesia. The changes in mean arterial pressure and heart rate ,anesthetic effects and adverse reaction rates during anesthesia were compared between the two groups. Results The reduction of mean arterial pressure of premedication/induction of anesthesia(T0)was more pronounced in the Fentanyl group than in the Remifentanil group(t=2.855 ,P=0.003) ,but the heart rate was lower in the Remifentanil group than in the Fentanyl group(t= 4.405 ,P= 0.000).The changes of heart rate and mean arterial pressure were more significant in the Fentanyl group than in Remifentanil group immediately after tracheal intubation (T1) ,during incision of skin(T2) ,immediately after suture of the abdomen (T3) and immediately after removal of the tracheal tube (T4) ( P ＜ 0.05 ). The spontaneous respiration recovery time ,blinking time ,extubation time ,force recovery time and recovery time were shorter in the Remifentanil group than in the Fentanyl group(P＜0.05).The incidence of anesthetic adverse reactions was lower in the Remifentanil group than in the Fentanyl group (10.3% , 4/39 vs.28.2% ,11/39 ,χ2= 4.044 ,P= 0.044). Conclusions Both Remifentanil and Fentanyl groups have good anesthetic effects in urological anesthesia ,but Remifentanil has less fluctuations of perioperative blood pressure and heart rate ,has higher recovery quality and less anesthetic adverse reactions. Therefore ,Remifentanil anesthesia is worthy of promotion.