Remifentanil Versus Fentanyl During Laparoscopic Hysterectomy
Status:
Unknown status
Trial end date:
2020-11-01
Target enrollment:
Participant gender:
Summary
Introduction- During laparoscopic procedures surgical field exposure is one of the crucial
aspects for a successful surgery. Exposure can be optimized by pneumoperitoneum, positioning
of the patient and muscle relaxation.
The European Association for Endoscopic Surgery has recommended using the lowest
intraperitoneal pressure allowing adequate exposure of the operative field rather than using
a routine pressure. A way to lower intraabdominal pressure during laparoscopic procedures is
to employ a deeper level of neuromuscular blockade.
Intravenous (IV) opioids such as fentanyl and remifentanil are commonly used to provide
analgesia and supplement sedation during general anesthesia.
In terms of analgesia, management of intraoperative stress, remifentanil exhibits similar
effects to fentanyl in adult healthy volunteers and surgical patients.
In clinical practice, if the surgeon asks for relaxation toward the end of the surgery, then
many anesthesiologists will increase the dose of the IV opioids. In our experience the use of
remifentanil achieves a better muscle relaxation and surgical space exposure with a lower
intraabdominal pressure and less need for a neuromuscular blockage as compared to fentanyl.
Thus, the investigators aimed to compare the use of fentanyl versus remifentanil during
laparoscopic hysterectomy. Because surgical complications due to inadequate exposure are a
rare event, the typical way to study this issue is to use surgeon's satisfaction score.