Supplementary Use of Fentanyl in Propofol—Remifentanil Based Anesthesia in Neurosurgery

Abstract

[Background] Fast recovery from anesthesia is obtainable by remifentanil, and that property is beneficial in neuroanesthesia because early detection of complications after craniotomies is important. However, postoperative analgesia appears to be another problem. To determine the suitable use of supplemental fentanyl, we investigated recovery properties from anesthesia in craniotomies.
[Materials and methods] Seventy-five patients undergoing scheduled neurosurgical procedures were included. Anesthesia was induced and maintained with propofol, remifentanil and vecuronium. Two (RF2) or 3 (RF3) μg/kg of fentanyl was administrated at closure but no fentanyl was administered in group R.
[Results] There were no differences among the groups in duration of anesthesia, amount of bleeding, dose of propofol, dose of remifentanil and recovery time. The frequency of hypertension at extubation was lower in group RF3 (P < 0.01) . Two and 1 patients complained of wound pain in groups R and RF2, respectively, but none in group RF3.
[Conclusion] Threeμg/kg of fentanyl is a suitable supplement in propofol-remifentanil-based anesthesia for neurosurgery.