Comparison of fentanyl and remifentanil in kidney transplant surgery

Objective To compare the hemodynamics during induction and maintenance of anesthesia and recovery profiles using fentanyl or remifentanil with isoflurane inhalation anesthesia in kidney transplant surgery.Methods 32 patients underwent renal transplantation were randomly divided into fentanyl group or remifentanyl group with 16 cases in each group.Anesthesia was induced with propofol(2 mg/kg) and either fentanyl(2.5 μg/kg) or remifentanil(2 μg/kg),and was maintained with isoflurane inhalation anesthesia and a continuous infusion of either fentanyl[0.03 μg/(kg·min)] or remifentanil[0.2 μg/(kg·min)].The hemodynamic changes of patients at different stages of anesthetic and surgical procedures and recovery profiles were compared.Results The hemodynamic changes of patients at different stages of anesthetic and surgical procedures in the remifentanil group were significantly smaller than those in the fentanyl group(P0.05).Times from stopping administration of anesthetics until full spontaneous respiration,eye opening,extuibation,and orientation were significantly less in the remifentanil group than in the fentanyl group(P0.05).The observer′s assessment of alertness/sedation(OAAS) scores and the mini mental states scores(MMSE) at tracheal extubation,30 min,1 h and 3 h after extubation were higher in the remifentanil group than in the fentanyl group(P0.05).There was no significantly difference between the two groups in the aspect of adverse reactions.Conclusion Remifentanil with isoflurane inhalation anesthesia in kidney transplant surgery is associated with better hemodynamic stability and recovery profile compared with fentanyl.