Korean J Anesthesiol.  2007 Jul;53(1):35-41. 10.4097/kjae.2007.53.1.35.

The Effect of Remifentanil with Sevoflurane in Subtotal Gastrectomy Patients with Patient Controlled Epidural Analgesia

• Ryu SH
• Lee DW
• Kwon JY

• KMID: 2238295
• DOI: http://doi.org/10.4097/kjae.2007.53.1.35

Abstract

BACKGROUND: Remifentanil is an ultra-short acting opioid, and its use has been known to be related to acute opioid withdrawal or tolerance. This study was performed to compare the hemodynamic response, recovery characteristics, and postoperative pain response after sevoflurane-remifentanil or sevoflurane anesthesia in subtotal gastrectomy patients.
METHODS
Sixty patients scheduled for gastrectomy were randomly allocated into two groups. Thoracic epidural catheterization was performed before anesthesia. Anesthesia was maintained with sevoflurane-remifentanil (SR group) or sevoflurane (SN group). We compared hemodynamic variables during surgery and recovery, the pain and sedation score during recovery, and the pain score and analgesic requirements during the postoperative period.
RESULTS
Intraoperative blood pressure and heart rates in the SR group were lower than in the SN group. There was no significant difference in extubation time and recovery time between patients in the two groups. The patients in the SN group showed more prompt recovery at 15 minutes after extubation. The VAS scores and analgesic demand of the SR group were greater than in the SN group.
CONCLUSIONS
Intraoperative use of remifentanil with sevoflurane may be related to increased postoperative pain.

Keyword

epidural anesthesia; postoperative pain; remifentanil; sevoflurane

MeSH Terms

Analgesia, Epidural*
Anesthesia
Anesthesia, Epidural
Blood Pressure
Catheterization
Catheters
Gastrectomy*
Heart Rate
Hemodynamics
Humans
Pain, Postoperative
Postoperative Period