ABSTRACT
This study was designed to compare the intra-operative and post-operative analgesic requirements
and side effects of using fentanyl infusion versus remifentanil infusion during short-duration
surgical procedures in children. The study comprised of 40 children randomly allocated into two
equal groups: fentanyl (F-group) or remifentanil (R-group). Both were administered a continuous
intravenous (i.v.) infusion. Anaesthetic recovery was assessed using the Brussels sedation scale
every 5 min from the time of entry till discharge from recovery room. Post-operative analgesia
was assessed throughout the first three post-operative (PO) hours using observational pain–
discomfort scale (OPS) and adverse events were recorded. Haemodynamic variables showed a
non-significant difference between both the groups. Patients who received remifentanil showed
significantly shorter time to spontaneous respiration, eye opening, extubation and verbalization
compared to those who received fentanyl. Discharge time was significantly shorter in R-group, and
18 patients fulfilled criteria for recovery-room discharge at ≤25 min with a significant difference
in favour of remifentanil. Fentanyl provided significantly better PO analgesia than remifentanil
and children in F-group showed a significantly lower mean cumulative OPS record than those in
R-group; however, the number of patients requiring rescue analgesia did not show a significant
difference between both the groups. Two cases in F-group and one in R-group had bradycardia,
one case in R-group had mild hypotension and PO vomiting had occurred in three patients in the
F-group and two patients in the R-group. In conclusion, remifentanil is appropriate for opioid-based
anaesthesia for paediatric patients as it provides haemodynamic stability and rapid recovery with
minimal post-operative side effects. |
