Fentanyl/alfentanil for pelvic laparoscopy

Alfentanil, a new narcotic analgesic, was compared to fentanyl in a technique of balanced anaesthesia using thiopentone 5 mg X kg-1 for induction of anaesthesia, and pancuronium 60 micrograms X kg-1 to facilitate intubation. The study group consisted of 80 female patients scheduled for pelvic laparoscopy. The total dose of alfentanil averaged 2.06 mg (range 1.5-2.5 mg) whereas the dose of fentanyl averaged 0.21 mg (range 0.1-0.25 mg). There was no significant difference between the two groups in duration of anaesthesia, time to extubation, verbal response time or time to orientation to person, place and time. Following intubation, there was a significant rise in heart rate and blood pressure (p less than 0.01) in both groups, but, again, there was no difference between groups. Postoperatively, the respiratory rate was not below 12 per minute for any patient in the study and was comparable for the two groups. The only significant side effect was postoperative nausea which occurred in over 40 per cent of patients and was not significantly different between the two groups. We conclude that alfentanil is a suitable narcotic drug for short surgical procedures on ambulatory patients, but the drug has no marked advantage over fentanyl for these procedures.