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[Remifentanil can reduce intraoperative movement during tympanoplastic surgery--a retrospective analysis]
Kota Kamizato1, Manabu Kakinohana, Satoko Saikawa
1Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0215.
Background:
This retrospective study compared remifentanil-sevoflurane anesthesia (RG) with fentanyl-sevoflurane anesthesia (FG) to determine which is accompanied with the lower incidence of intraoperative movement during tympanoplastic surgery under intraoperative facial nerve monitoring.
Methods:
We reviewed 91 patients undergoing elective tympanoplastic surgery under intraoperative facial nerve monitoring. All patients were allocated into two groups; RG (48 subjects) and FG (43 subjects). Although vecuronium was given to facilitate endotracheal intubation, additional muscle relaxants were administered in case of intraoperative movement. The intraoperative consumption of sevoflurane, the additional use of vecuronium, incidence of intraoperative movement, and the effect-site concentration of remifentanil or fentanyl were calculated from the anesthetic records.
Results:
Both the consumption of sevoflurane and the additional use of vecuronium were significantly less in the RG group than in the FG group. Incidence of intraoperative movement in RS was lower than that in FG (RG:FG = 6.2:53.5%, P = 0.002).
Conclusions:
According to our data, remifentanil-sevoflurane anesthesia can reduce the incidence of intraoperative movement during tympanoplastic surgery. This lower incidence of intraoperative movement with RG may be owing to the higher effect-site concentration of remifentanil.
Insights
Remifentanil-sevoflurane anesthesia significantly reduced intraoperative movement during tympanoplasty compared to fentanyl-sevoflurane anesthesia. This suggests remifentanil-sevoflurane is a more effective anesthetic choice for this procedure.
Area of Science:
- Anesthesiology
- Surgical Anesthesia
Background:
- Tympanoplasty requires careful anesthetic management to prevent intraoperative movement.
- Comparing remifentanil-sevoflurane (RG) and fentanyl-sevoflurane (FG) anesthesia is crucial for optimizing patient safety during surgery.
Purpose of the Study:
- To compare the incidence of intraoperative movement between remifentanil-sevoflurane and fentanyl-sevoflurane anesthesia during tympanoplasty.
- To evaluate anesthetic agent consumption and muscle relaxant use in both groups.
Main Methods:
- Retrospective review of 91 patients undergoing tympanoplasty with intraoperative facial nerve monitoring.
- Patients were divided into remifentanil-sevoflurane (n=48) and fentanyl-sevoflurane (n=43) groups.
- Anesthetic records were analyzed for sevoflurane consumption, additional vecuronium use, and intraoperative movement incidence.
Main Results:
- Remifentanil-sevoflurane anesthesia group showed significantly lower incidence of intraoperative movement (6.2%) compared to fentanyl-sevoflurane group (53.5%).
- Sevoflurane consumption and additional vecuronium use were significantly lower in the remifentanil-sevoflurane group.
- Higher effect-site concentration of remifentanil was noted in the remifentanil-sevoflurane group.
Conclusions:
- Remifentanil-sevoflurane anesthesia is associated with a reduced incidence of intraoperative movement during tympanoplasty.
- The higher effect-site concentration of remifentanil may contribute to the decreased movement observed.
- This finding supports the use of remifentanil-sevoflurane for improved anesthetic control in tympanoplasty.
