[Anesthetic management with remifentanil for tracheobronchial stent insertion]

Although remifentanil produces respiratory depression, its very short duration of action provides a great advantage for the control of hemodynamics during anesthesia for tracheobronchial stent insertion. We compared remifentanil with fentanyl during propofol-based anesthesea for anesthetic management for tracheobronchial stent insertion.

Seventy-eight patients were analyzed retrospectively by anesthetic chart review. Thirty-nine patients were anesthetized with bolus infusion of fentanyl with propofol (group PF). The remaining 39 patients were anesthetized with continuous infusion of remifentanil with propofol (group PR). Demographic data, duration of anesthesia and operative procedure, airway management, duration of emergence, dose of propofol, fentanyl and remifentanil, and use of cardiovascular drug were analyzed for the 2 groups. Chi-square tests and Student-t test were used for statistical analysis. Differences were considered significant when P was below 0.05.

The dose of propofol was less in the PR group than in the PF group (0.10 +/- 0.04 mg x kg(-1) x min(-1) vs. 0.14 +/- 0.04 mg x kg(-1) x min(-1), P = 0.025). The duration of emergence was shorter in the PR group than in the PF group (9.0 +/- 6.8 min vs. 12.5 +/- 6.2 min).

We conclude that the continuous infusion of low dose remifentanil with propofol produce more efficient respiratory and hemodynamic stability than the bolus infusion of fentanyl with propofol during anesthesia for tracheobronchial stent insertion.