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Remifentanil vs. fentanyl during interventional rigid bronchoscopy under general anaesthesia and spontaneous assisted ventilation

Published online by Cambridge University Press:  16 August 2006

G. Natalini ,
P. Fassini ,
V. Seramondi ,
G. Amicucci ,
C. Toninelli ,
S. Cavaliere  and
A. Candiani
G. Natalini
Affiliation:
Department of Anaesthesia and Intensive Care, University of Brescia, Spedali Civili Brescia, Italy Present address: Department of Anaesthesia and Intensive care, Poliambulanza, Brescia, Italy.
P. Fassini
Affiliation:
Department of Anaesthesia and Intensive Care, University of Brescia, Spedali Civili Brescia, Italy
V. Seramondi
Affiliation:
Department of Anaesthesia and Intensive Care, University of Brescia, Spedali Civili Brescia, Italy
G. Amicucci
Affiliation:
Department of Anaesthesia and Intensive Care, University of Brescia, Spedali Civili Brescia, Italy
C. Toninelli
Affiliation:
Respiratory Endoscopy and Laser Therapy Centre, Spedali Civili Brescia, Italy
S. Cavaliere
Affiliation:
Respiratory Endoscopy and Laser Therapy Centre, Spedali Civili Brescia, Italy
A. Candiani
Affiliation:
Department of Anaesthesia and Intensive Care, University of Brescia, Spedali Civili Brescia, Italy
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Abstract

The treatment of tracheo-bronchial diseases with rigid bronchoscopy requires general anaesthesia without tracheal intubation. Spontaneous assisted ventilation is a safe modality of ventilation. In this study the use of remifentanil and fentanyl is compared during rigid bronchoscopy with spontaneous assisted ventilation. Ninety high-risk patients received fentanyl or remifentanil with propofol for general anaesthesia. During the maintenance fentanyl was delivered at 6.1±4.6 μg kg−1 h−1 and remifentanil at 0.15±0.07 μg kg−1min−1. The same degree of intra-operative respiratory acidosis with similar good operating conditions resulted in both groups. Patients treated with remifentanil recovered more quickly compared with those in the fentanyl group (3.8±2 vs. 10.4±9.2 min, P<0.001). In conclusion, the use of remifentanil during rigid bronchoscopy under general anaesthesia with spontaneous assisted ventilation is safe and assures good operating conditions. Moreover, remifentanil permits a more rapid recovery than fentanyl. The dose of remifentanil is higher than previously described for spontaneously breathing patients.

Keywords

fentanylremifentanilbronchoscopyanaesthesia
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 16 , Issue 9 , September 1999 , pp. 605 - 609
Copyright
1999 European Society of Anaesthesiology

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