Remifentanil vs. fentanyl during interventional rigid bronchoscopy under general anaesthesia and spontaneous assisted ventilation

The treatment of tracheo-bronchial diseases with rigid bronchoscopy require s general anaesthesia without tracheal intubation. Spontaneous assisted ven tilation is a safe modality of ventilation. In this study the use of remife ntanil and fentanyl is compared during rigid bronchoscopy with spontaneous assisted ventilation. Ninety high-risk patients received fentanyl or remife ntanil with propofol for general anaesthesia. During the maintenance fentan yl was delivered at 6.1 +/- 4.6 mu g kg(-1) h(-1) and remifentanil at 0.15 +/- 0.07 mu g kg(-1)min(-1). The same degree of intra-operative respiratory acidosis with similar good operating conditions resulted in both groups. P atients treated with remifentanil recovered more quickly compared with thos e in the fentanyl group (3.8 +/- 2 vs. 10.4 +/- 9.2 min, P < 0.001). In con clusion, the use of remifentanil during rigid bronchoscopy under general an aesthesia with spontaneous assisted ventilation is safe and assures good op erating conditions. Moreover, remifentanil permits a more rapid recovery th an fentanyl. The dose of remifentanil is higher than previously described f or spontaneously breathing patients.