ALFENTANIL OR FENTANYL DURING ISOFLURANE-BASED ANESTHESIA FOR DAY-CARE KNEE ARTHROSCOPY

Forty patients agreed to participate in a study to compare whether fen tanyl or alfentanil used as analgesic is associated with quicker recov ery following anaesthesia for outpatient arthroscopy procedure. Psycho motor tests including choice reaction time (CRT), perceptive accuracy rest (PAT) and finger tapping test (FTT) were done prior to induction of anaesthesia with propofol (2-3 mg kg(-1)). Patients were then divid ed into two groups: Group F (fentanyl) received 0.1 mg fentanyl prior to start of surgery and thereafter 0.05 mg every 30 min during the pro cedure. Group A (alfentanil) received 0.5 mg alfentanil prior to the o nset of surgery and 0.25 mg every 15 min thereafter. Anaesthesia was t hen maintained using isoflurane (0.5-2%) in oxygen and air (Fio(2) 0.3 3) during spontaneous respiration with a face mask in a Bain's system. Psychomotor tests were repeated every 45 min postoperatively Clinical recovery, visual analogue pain intensity score (VAS) and time to disc harge home were also assessed by a nurse blind to the method used. Pat ients in Group A returned to baseline values on the FTT after 90 min w hile those in Group F did not return to baseline values until 135 min after the end of the operation. Clinical recovery and time to discharg e home (''home ready'') were also significantly longer in Group F Ther e was no difference in recovery as seen in the PAT and CRT between the groups. Also, there was no difference in the incidence of side effect s and the pain intensity (VAS) scores were similar in the two groups a l all time periods. We conclude that recovery following alfentanil is quicker compared to fentanyl when anaesthesia is based on isoflurane.