Abstract
Bakground & Objective: Necessity for rapid and safe recovery of patients for coming back to daily life with consideration the daily – increased development of outpatient surgeries is the main point. This study is comparing recovery time post operative nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in anesthesia of elderly patients.
Materials and Methods: In this double-blind clinical trial 40 elderly patient scheduled to cataract surgery with general anesthesia were studied. The patients were selected randomly into two groups and in each group alfentanil or remifentanil was injected one minute before induction of anesthesia during 30 seconds. Both two groups were under general anesthesia with same method and during the anesthesia alfentanil and remifentanil infused for each groupe respectively. The time intervals between end of anesthesia and spontaneous respiration, eyes opening with simulation, verbal response, nausea and vomiting incidence in recovery and the time of discharge from recovery room were recorded.
Results: The time of spontaneous respiration in alfentanil group 1.3 minute was shorter than remifentanil group, But statistically, the difference was not significant (P=0.08). The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different in two groups. During recovery, nausea and vomiting in remifentanil group (30% of patients) was significantly more than alfentanil group (5% of patients) (P=0.045).
Conclusions: With consideration that faster return of spontaneous respiration after infusion of alfentanil than remifentanil group and espessially the significantly lower incidence of postoperative nausea and vomiting in alfentanil group, the infusion of alfentanil as opioid supplement in anesthesia of elderly patients espessially in out patient surgery is suggested.