Comparison of anesthetic effects and peroperative tolerance of remifentanil and alfentanil based Total Intravenous Anesthesia (TIVA) [Total İntravenöz Anestezide (TİVA) remifentanil ile alfentanilin anestezik etkilerinin ve peroperatif toleransin karşilaştirilmasi]
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Aim: The aim of this study was to compare the anesthetic offerts and peroperative tolerance: of remifentanil and alfentanil based total intravenous anesthesia (TI-VA). Materials and Methods: In this randomized, double-blinded study was applied at thirty patients of ASA physical status I and II who were scheduled for elective abdomen and urogenitale surgery lasting at least 2 h. Patients were randomly allocated to receive either remifentanil-propofol (group remifentanil) (n=15) or alfentanil-propofol (group alfentanil) (n-15). Anesthesia was induced with remifentanil 1 ?g kg-1 or alfentanil 40 ?g kg-1 with propofol 1.5 ?g kg-1 and maintained with infusion of propofol 70 ?g kg-1 dk-1 and either remifentanil 0.5 ?g kg-1 dk-1 or alfentanil 1 ?g kg-1 dk-1. In both groups, propofol infusions were constanted. Opioid dose was increased or decreased 50 % according to necessity. Hemodynamic parameters (systolic and diastolic blood pressure, and heart rate), extubation time, Aldrete recovery score, and consumption of remifentanil and alfentanil during operation were recorded. Frequency of nausea, vomiting and other side effects were recorded postoperatively. Results: Duration of operation and demographic data were similar among groups. The blood pressure and heart rate values of remifentanil group at tracheal intubation time were significantly higher than the alfentanil group (127.93±5.64 mmHg vs. 98.53±6.25 mmHg and 94.53±4.75 beat min-1 vs. 79.46±3.91 beat min-1, respectively) (p<0.05). In remifentanil group, the extubation time was shorter than the alfentanil group (8.60±0.70 min vs. 14.00±1.40 min, respectively) (p<0.05). In both groups, opioid infusions were not increased during operation. Total consumption of remifentanil und alfentanil during operation were as follows 5.9±0.76 mg, 13.3±2.1 mg respectively. Conclusions: Although alfentanil provided better hemodynamic stability than remifentanil at tracheal intubation, extubation time was longer than remifentanil. However no development of tolerance was observed during remifentanil and alfentanil infusion.