Journal of Health and Medical Sciences
ISSN 2622-7258
Published: 03 June 2022
Comparison of Intravenous Fentanyl and Intravenous Remifentanil on Emergence Time and Discharge Time in Patients Undergoing Odontectomy: An Observational Analytical Review
Suwarman, Osmond Muftilov, Muhammad Luthfi Hidayat
Padjajaran University / Hasan Sadikin General Hospital, Indonesia
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10.31014/aior.1994.05.02.215
Pages: 81-87
Keywords: Discharge Time, Fentanyl, Odontectomy, Recovery Time, Remifentanil
Abstract
Background: Recovery time and fast patient discharge after surgery are goals of fast-track surgery that uses the concept of ERAS (Enhanced Recovery After Surgery) to minimize pain, speed up recovery, and reduce pain and complications. Fast-track surgeries such as odontectomy require drugs with a fast onset of action and short duration hence the patient can recover from the drugs as soon as possible. The use and types of opioids have been developed for optimal fast-track surgery. One of the most widely used opioids is remifentanil. Purpose: This study aims to compare the administration of fentanyl and remifentanil to the emergence and discharge time of post-odontectomy patients with general anesthesia. Methods: Patients were divided into two groups, the fentanyl group (group F, n=21) and the remifentanil group (group R, n=21). This study used a retrospective cohort analysis of the medical records of 42 patients with elective odontectomy surgery for the period December 2020 to June 2021 at RSUP dr. Hasan Sadikin Bandung. Emergence time was assessed using the OAA/S score and discharge time was considered using the modified Aldrete score. Results: This study showed a significant difference between the emergence time in group R (168+47.98 seconds) and group F (368+58.16 seconds) with a p-value = 0.0001. There was a significant difference between the discharge time in group R (20.00+7.24 minutes) and group F (58.57+12.46 minutes) with a p-value = 0.001. Conclusion: Recovery time and discharge time for patients receiving remifentanil were faster than for patients receiving fentanyl for odontectomy.
References
Awad, I. T., & Chung, F. (2006). Factors affecting recovery and discharge following ambulatory surgery. Canadian Journal of Anesthesia, 53(9), 858–872. https://doi.org/10.1007/BF03022828
Buchanan, F. F., Myles, P. S., & Cicuttini, F. (2011). Effect of patient sex on general anaesthesia and recovery. British Journal of Anaesthesia, 106(6), 832–839. https://doi.org/10.1093/bja/aer094
DG, W., Verco, S., Woods, B., & Savage, J. (2021). Dental Sedation: The Advantages of Propofol and Remifentanil via Target Controlled Infusions. International Journal of Dentistry and Oral Health, 7(5), 1–5. https://doi.org/10.16966/2378-7090.368
Gül, R., Hizli, Ş., Kocamer, B., Koruk, S., Şahin, L., Kilinçaslan, H., & Sariçiçek, V. (2013). The safety and efficacy of remifentanil compared to fentanyl in pediatric endoscopy. Turkish Journal of Medical Sciences, 43(4), 611–616. https://doi.org/10.3906/sag-1208-3
Katznelson, R., & Fisher, J. A. (2015). Fast wake-up time in obese patients: Which anesthetic is best? Canadian Journal of Anesthesia, 62(8), 847–851. https://doi.org/10.1007/S12630-015-0406-Z
Kovac, A. L., & Summers, K. L. (2009). Comparison of remifentanil versus fentanyl general anesthesia for short outpatient urologic procedures. Signa Vitae, 4(2), 23–29. https://doi.org/10.22514/SV42.102009.5
McLean House, L., Calloway, N., Sandberg, W., & Ehrenfeld, J. (2016). Prolonged patient emergence time among clinical anesthesia resident trainees. Journal of Anaesthesiology Clinical Pharmacology, 32(4), 446–452. https://doi.org/10.4103/0970-9185.194776
Min, J., Kim, Y. H., Chae, Y. K., Lee, W. K., Choi, S., Chai, H. S., & Choi, Y. S. (2008). A Comparison of Remifentanil versus Fentanyl as an Adjuvant to Propofol Anesthesia for Ureteroscopic Lithotripsy. Korean Journal of Anesthesiology, 54(3), 283. https://doi.org/10.4097/kjae.2008.54.3.283
Misal, U., Joshi, S., & Shaikh, M. (2016). Delayed recovery from anesthesia: A postgraduate educational review. Anesthesia: Essays and Researches, 10(2), 164–172. https://doi.org/10.4103/0259-1162.165506
Pavlin, D. J., Rapp, S. E., Polissar, N. L., Malmgren, J. A., Koerschgen, M., & Keyes, H. (1998). Factors affecting discharge time in adult outpatients. Anesthesia and Analgesia, 87(4), 816–826. https://doi.org/10.1097/00000539-199810000-00014
Permatasari, E., C. Lalenoh, D., & Rahardjo, S. (2017). Pulih Sadar Pascaanestesi yang Tertunda. Jurnal Neuroanestesi Indonesia, 6(3), 187–194. https://doi.org/https://doi.org/10.24244/jni.vol6i3.48
Syroid, N. D., Johnson, K. B., Pace, N. L., Westenkow, D. R., Tyler, D., Brühschwein, F., Albert, R. W., Roalstad, S., Costy-bennett, S., & Egan, T. D. (2010). Response surface model predictions of emergence and response to pain in the recovery room: an evaluation of patients emerging from an isoflurane and fentanyl anesthetic. Anesth Analg, 111(2), 380–386. https://doi.org/10.1213/ane.0b013e3181b11289.Response
Twersky, R. S., Jamerson, B., Warner, D. S., Fleisher, L. A., & Hogue, S. (2001). Hemodynamics and emergence profile of remifentanil versus fentanyl prospectively compared in a large population of surgical patients. Journal of Clinical Anesthesia, 13(6), 407–416. https://doi.org/10.1016/S0952-8180(01)00292-6