Mehmet Emin ORHAN, Uğur GÖKTAŞ, Ali SIZLAN, Ceyda ÖZHAN, Mehmet Özgür ÖZHAN, Ercan KURT

Comparison of remifentanil, alfentanil, and fentanil -administered with propofol to facilitate laryngeal mask insertion

Amaç:Minör cerrahideki hastalarda propofole eklenen farklı dozlardaki remifentanil, fentanil ve alfentanilin etkilerini birbirleriyle ve plasebo kontrollü olarak karşılaştırmayı amaçladık. Yöntem ve gereç: Bu çalışma çift kör, çok merkezli (GATA-Ankara ve 100. Yıl Üniversitesi-Van), plasebo kontrollü olarak yapıldı. Etik komite onayından sonra ASA I ve II sınıfı, yetişkin, 18-65 yaş arasında çalışmayı kabul eden 141 hasta çalışmaya alındı. İv. olarak hastalardan grup F’ye (n = 33) 1 μg kg–1 fentanil, grup A’ya (n = 33) 10 μg kg–1 alfentanil, grup R’ye (n = 36) 0,5 μg kg–1 remifentanil ve kontrol grubu C’ye (n = 39) salin, 2,5 mg kg–1 katkısız propofole ilave olarak 30 sn. üzerindeki sürede verildi. 90 sn. sonra LMA yerleştirildi. LMA yerleştirme kolaylığı değerlendirildi. Girişim sayısı, hava yolu sağlama kolaylığı ve hemodinamik değişiklikler kaydedildi.

Larengeal mask yerleştirmede propofole eklenen remifentanil, alfentanil ve fentanilin etkilerinin karşılaştırılması

Aim: To compare the efficacy of different doses of fentanil, remifentanil, and alfentanil co-administered with propofol in patients undergoing minor surgery. Materials and methods: This double-blind, multi-centered, placebo-controlled study was conducted in 2 medical centers. One hundred forty-one ASA class I and II adult patients aged 18-65 years were included in the study. Patients received i.v. 1 μg kg–1 fentanil (group F, n = 33), 10 μg kg–1 alfentanil (group A, n = 33), 0.5 μg kg–1 remifentanil (group R, n = 36), or saline (control group, n = 39) co-administered with propofol 2.5 mg kg–1 without additives over 30 s. An LMA was inserted 90 s later. Conditions for the LMA insertion were assessed. The number of attempts, airway quality, and hemodynamic changes were recorded.Results: There were no significant differences in the demographic data among the groups. The LMA was more easily placed in the remifentanil group compared with the other groups . All first attempts for the LMA insertion were successful in the remifentanil group. When the opiates groups were compared with the control group, easier insertion rates were detected in all the opiate groups. LMA insertion was easiest in the remifentanil group, followed by the alfentanil, fentanil, and control groups, in that order. Heart rates and blood pressures were reduced in all groups, but no treatment was required. Conclusion: Opiates co-administered with propofol improved the LMA insertion conditions compared to propofol alone. Out of the opiates, remifentanil had the highest success rate.

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