An open, randomized comparison of alfentanil, remifentanil and alfentanil followed by remifentanil in anaesthesia for craniotomy

J. R. Sneyd*, A. Whaley, H. L. Dimpel, C. J.H. Andrews

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We studied 52 adults undergoing elective craniotomy, allocated randomly to one of three opioid treatments: alfentanil 50 μg kg-1 followed by 0.833 μg kg-1 min-1 until dural closure (group Alf.); alfentanil 50 μg kg-1 followed by 0.833 μg kg-1 min-1 for 2 h, then remifentanil 0.25 μg kg min-1 (group Alf.-Remi.); or remifentanil 1 μg kg-1 followed by 0.5 μg kg-1 min-1 reducing to 0.25 μg kg-1 min-1 after craniotomy (group Remi.). Anaesthesia was maintained with infusion of propofol and 66% nitrous oxide in oxygen. Infusions of propofol and remifentanil were stopped at head bandaging. Group Remi. had the least intraoperative haemodynamic responses and group Alf. the most (P < 0.05). Times to tracheal extubation and obey commands were similar in all groups. In all patients in group Alf.-Remi. and group Remi., the trachea was extubated 27 min from the end of anaesthesia; three patients in group Alf. were slower to recover. Use of analgesia in the recovery room and time to transfer to the neurosurgical unit were similar in the three groups.

Original languageEnglish
Pages (from-to)361-364
Number of pages4
JournalBritish Journal of Anaesthesia
Volume81
Issue number3
DOIs
Publication statusPublished - 1998

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Keywords

  • Analgesics opioid, alfentanil
  • Analgesics opioid, remifentanil
  • Pharmacokinetics, alfentanil
  • Pharmacokinetics, remifentanil
  • Surgery, neurological

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