| The Effect of Fentanyl and Remifentanil on Postoperative Nausea and Vomiting, and Pain after Gynecologic Laparoscopic Ovarian Cyst Enucleation by Balanced Anesthesia with Sevoflurane. |
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Woo Kyung Lee, Yong Bum Kim, Seung Ho Choi, Young Keun Chae, Nam Geun Hong, JongHoon Kim |
1Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Goyang, Korea.
2Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. jhkim007@yumc.yonsei.ac.kr
3Department of Anesthesia and Pain Medicine Research Institute, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
Opioids are known to increase the incidence of postoperative nausea and vomiting (PONV). Remifentanil is an ultrashort-acting opioid with a potent analgesic effect and is useful for rapid emergence. This study compared the effect of remifentanil on the incidence and severity of PONV and postoperative pain with that of fentanyl in patients undergoing laparoscopic surgery, which is normally associated with a high incidence of PONV.
METHODS
Forty-four adult female patients, who were scheduled for laparoscopic ovarian cyst enucleation, were randomly assigned to either the remifentanil or fentanyl group. Anesthesia was induced with propofol after injecting fentanyl 2 microgram/kg or remifentnail 1 microgram/kg and was maintained with sevoflurane. Remifentanil and fentanyl was infused continuously in the range of 0.2-0.5 microgram/kg/min and 0.03-0.05 microgram/kg/min, respectively. Ketorolac 0.5 mg/kg was injected 30 min before the end of surgery. The incidence and severity of PONV and pain were recorded upon arrival at the recovery room and 2, 6, 12 and 24 hours thereafter.
RESULTS
The incidence and severity of PONV and pain were significantly higher in the remifentanil group upon arrival at the recovery room than in the fentanyl group. The incidence and severity of PONV and pain at the other measurement times were similar.
CONCLUSIONS
Despite the ultrashort action duration of the remifentanil, the incidence and severity of PONV and postoperative pain immediately after awakening was higher in the remifentanil group undergoing laparoscopic ovarian cyst enucleation than in the fentanyl group. However, there were no significant differences after two hours in the recovery phase. |
| Key Words:
fentanyl; nausea and vomiting; pain; remifentanil |
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