Remifentanil-propofol versus sufentanil-propofol anaesthesia for supratentorial craniotomy: A randomized trial

Klaus Gerlach*, T. Uhlig, M. Hüppe, G. Nowak, A. Schmitz, L. Saager, A. Grasteit, P. Schmucker

*Korrespondierende/r Autor/-in für diese Arbeit
49 Zitate (Scopus)


Background and objective: Remifentanil has unique pharmacokinetics that might allow faster recovery after neurosurgery. We investigated the effects of a propofol/sufentanil versus a remifentanil/propofol regimen on the primary end-point tracheal extubation time. Methods: In the Neurosurgery Department of a University Hospital, 36 patients awaiting craniotomy for supratentorial tumour resection were randomly assigned to one of two study groups. In the sufentanil/propofol group, anaesthesia was induced with 0.5 μg kg -1 sufentanil and 1-2 mg kg-1 propofol. Propofol infusion and boluses of sufentanil were administered for maintenance. In the remifentanil/propofol group, anaesthesia was started with an infusion of remifentanil (0.2-0.35 μg kg-1 min-1) and a bolus of propofol (1.5-2 mg kg-1). Patients received a propofol infusion and a remifentanil infusion for maintenance of anaesthesia. Recovery times were taken from cessation of the propofol infusion. In addition, data about self-reported nausea and vomiting, pain and analgesic requirements were collected. Results: Patients in the remifentanil/propofol group were extubated earlier (mean times 6.4 (±SD 4.7) versus 14.3 (±9.2) min; P = 0.003). The two groups were similar with respect to postoperative nausea and vomiting, and patient-reported pain scores. Fifty per cent of the remifentanil/propofol patients and 88% of the sufentanil/propofol patients required no analgesics within 1 h after operation (P = 0.03). Conclusions: The remifentanil/propofol regimen provided quicker recovery. The two regimens were similar in terms of postoperative nausea and vomiting and patient-reported pain scores, but patients in the remifentanil/propofol group required more analgesics within 1 h postoperatively.

ZeitschriftEuropean Journal of Anaesthesiology
Seiten (von - bis)813-820
PublikationsstatusVeröffentlicht - 01.10.2003


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