Remifentanil versus fentanyl in total intravenous anesthesia for lumbar spine surgery: a retrospective cohort study.

Published in J Clin Anesth. 2015 Aug;27(5):391-5

Authors: Thomas B et al

STUDY OBJECTIVE:

The aim of this study was to compare the speed of anesthetic recovery and the perioperative analgesic requirements in patients who received total intravenous anesthesia (TIVA) with either remifentanil-propofol or fentanyl-propofol for lumbar spine surgery.

DESIGN:

Retrospective cohort study.

SETTING:

Operating room, postanesthesia care unit, and general surgical ward.

PATIENTS:

One hundred six patients (53 in each group) with American Society of Anesthesiologists status I, II, or III who received either remifentanil-propofol TIVA or fentanyl-propofol TIVA for elective lumbar vertebral disc surgery.

MEASUREMENTS:

Patient demographics, total duration of anesthesia relative to surgical duration, time to emergence from anesthesia after completion of surgery, length of stay in the postanesthesia care unit, and requirements for opioid analgesia, nonopioid analgesia, and antiemetics in the perioperative period.

MAIN RESULTS:

No differences in anesthesia time, emergence time, or length of stay in the postanesthesia care unit were found between the remifentanil-propofol and fentanyl-propofol groups. Postoperative opioid and nonopioid analgesic use was significantly higher in the remifentanil-propofol group.

CONCLUSIONS:

Remifentanil and fentanyl are equally efficient with regard to the speed of patient turnover when used as part of TIVA for lumbar disc surgery, but remifentanil use is associated with increased perioperative analgesic requirements.