A comparison of remifentanil and sufentanil as adjuvants during sevoflurane anesthesia with epidural analgesia for upper abdominal surgery: Effects on postoperative recovery and respiratory function

We compared the recovery profile and postoperative Spo(2) after the adminis tration of general anesthesia with either sevoflurane-remifentanil or sevof lurane-sufentanil in 30 healthy patients undergoing upper abdominal surgery . They were randomly allocated to receive general anesthesia with sevoflura ne and small doses of either remifentanil (n = 15) or sufentanil (n = 15), followed by postoperative epidural analgesia. The median sevoflurane minimu m alveolar anesthetic concentration-hour was 2.3 (1.2-6.3) in group Remifen tanil and 2.6 (1.4-5.2) in group Sufentanil (P = 0.39), while the median co nsumption of remifentanil was 1.3 mg (0.7-3.4 mg) and sufentanil 0.09 mg (0 .05-0.6 mg). Tracheal extubation required 10 min (6-18 min) with remifentan il and 14 min (8-24 min) with sufentanil (P = 0.05); however, no difference s in time to discharge from the recovery area were reported (24 min [12-75 min] with remifentanil and 30 min [12-135 min] with sufentanil; P = 0.35). From the first to seventh hour after surgery, Spo(2) was decreased more in the sufentanil than in the remifentanil group (P = 0.001), and seven patien ts in the sufentanil group showed at least one episode with Spo(2) less tha n or equal to 90% for more than 1 min (P = 0.006) (median: 1 episode; range : 0-17 episodes; P = 0.003). When added to sevoflurane, remifentanil is as effective as sufentanil during the intraoperative period, but provides shor ter time to tracheal extubation and fewer effects on postoperative Spo(2) i n the first 7 h after surgery.