Recovery of Psychomotor Function After Total Intravenous Anesthesia with Remifentanil-propofol or Fentanyl-propofol

Overview

Journal J Anesth

Specialty Anesthesiology

Date 2011 Nov 4

PMID 22048284

Citations 8

Authors

Aki Takayama

Shigeki Yamaguchi

Kazuyoshi Ishikawa

Mio Shinozaki

Yoshiyuki Kimura

Masaru Nagao

Toshimitsu Kitajima

Affiliations

Soon will be listed here.

Abstract

Purpose: Total intravenous anesthesia (TIVA) with propofol combined with remifentanil or fentanyl has commonly been used to achieve general anesthesia. The purpose of this study was to examine recovery of psychomotor function, by use of the Trieger dot test, after TIVA with remifentanil-propofol or with fentanyl-propofol.

Methods: Forty patients were randomly divided into two groups of 20, to receive TIVA with either remifentanil-propofol (group R) or fentanyl-propofol (group F). Anesthesia was induced by intravenous injection of propofol. In group R, remifentanil at 0.3 μg/kg/min was infused continuously during surgery. In group F, 3 μg/kg fentanyl was injected as an initial dose and 1 μg/kg fentanyl was administered intravenously every 30 min during surgery. Psychomotor function, as measured by the Trieger dot test, was evaluated before anesthesia and 30, 60, 90, 120, and 150 min after the end of TIVA.

Results: From assessment of the Trieger dot test, the number of dots missed in group R from 30 to 120 min after the end of TIVA was significantly lower than in group F. The maximum distance of dots missed in group R from 30 to 120 min after the end of TIVA was significantly shorter than in group F. The average distance of dots missed in group R from 30 to 120 min after the end of TIVA was significantly shorter than in group F.

Conclusion: Recovery of psychomotor function in TIVA with remifentanil-propofol is faster than that in TIVA with fentanyl-propofol.

Citing Articles

Comparison of Remimazolam-Flumazenil and Propofol on Psychomotor Function and Emergence Following General Anesthesia in Surgical Abortion: A Randomized Controlled Trial.

Gu J, Liu Y, Lin X, Fu L, Liu J, Sun B Drug Des Devel Ther. 2025; 18:6447-6457.

PMID: 39758228 PMC: 11697650. DOI: 10.2147/DDDT.S486892.

Remimazolam Compared to Propofol for Total Intravenous Anesthesia with Remifentanil on the Recovery of Psychomotor Function: A Randomized Controlled Trial.

Shimizu T, Takasusuki T, Yamaguchi S Adv Ther. 2023; 40(10):4395-4404.

PMID: 37490257 PMC: 10499674. DOI: 10.1007/s12325-023-02615-w.

Comparison of Recovery Profiles of Patients Undergoing Endoscopic Lumbar Discectomy under Desflurane, Propofol, or Sevoflurane Anesthesia: A Randomized, Prospective, Clinical, Comparative Study.

Verma A, Haldar R, Srivastava S, Das K, Mishra P J Neurosci Rural Pract. 2022; 13(2):226-235.

PMID: 35694079 PMC: 9187405. DOI: 10.1055/s-0042-1743443.

Time course of psychomotor recovery after intravenous dexmedetomidine infusion as a part of balanced anaesthetic technique: A randomised, double-blind study.

Mishra S, Chandrasekaran A, Parida S, Senthilnathan M, Bidkar P, Gupta S Indian J Anaesth. 2019; 63(8):623-628.

PMID: 31462807 PMC: 6691630. DOI: 10.4103/ija.IJA_192_19.

Comparison of Fentanyl, Remifentanil, Sufentanil and Alfentanil in Combination with Propofol for General Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Sridharan K, Sivaramakrishnan G Curr Clin Pharmacol. 2019; 14(2):116-124.

PMID: 30868958 PMC: 7011685. DOI: 10.2174/1567201816666190313160438.

References

Gerlach K, Uhlig T, Huppe M, Nowak G, Schmitz A, Saager L . Remifentanil-propofol versus sufentanil-propofol anaesthesia for supratentorial craniotomy: a randomized trial. Eur J Anaesthesiol. 2003; 20(10):813-20. View

Alhashemi J, KaKi A . Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy. Can J Anaesth. 2006; 53(5):449-55. DOI: 10.1007/BF03022616. View

Suttner S, Boldt J, Schmidt C, Piper S, Kumle B . Cost analysis of target-controlled infusion-based anesthesia compared with standard anesthesia regimens. Anesth Analg. 1999; 88(1):77-82. DOI: 10.1097/00000539-199901000-00015. View

Mi W, Sakai T, Kudo T, Kudo M, Matsuki A . The interaction between fentanyl and propofol during emergence from anesthesia: monitoring with the EEG-Bispectral index. J Clin Anesth. 2003; 15(2):103-7. DOI: 10.1016/s0952-8180(02)00510-x. View

De Witte J, Alegret C, Sessler D, Cammu G . Preoperative alprazolam reduces anxiety in ambulatory surgery patients: a comparison with oral midazolam. Anesth Analg. 2002; 95(6):1601-6, table of contents. DOI: 10.1097/00000539-200212000-00024. View

Martorano P, Aloj F, Baietta S, Fiorelli A, Munari M, Paccagnella F . Sufentanil-propofol vs remifentanil-propofol during total intravenous anesthesia for neurosurgery. A multicentre study. Minerva Anestesiol. 2008; 74(6):233-43. View

Wilhelm W, Schlaich N, Harrer J, Kleinschmidt S, Muller M, Larsen R . Recovery and neurological examination after remifentanil-desflurane or fentanyl-desflurane anaesthesia for carotid artery surgery. Br J Anaesth. 2001; 86(1):44-9. DOI: 10.1093/bja/86.1.44. View

Newman M, Trieger N, Miller J . Measuring recovery from anesthesia--a simple test. Anesth Analg. 1969; 48(1):136-40. View

Kapila A, Glass P, Jacobs J, Muir K, Hermann D, Shiraishi M . Measured context-sensitive half-times of remifentanil and alfentanil. Anesthesiology. 1995; 83(5):968-75. DOI: 10.1097/00000542-199511000-00009. View

10.

Shinozaki M, Usui Y, Yamaguchi S, Okuda Y, Kitajima T . Recovery of psychomotor function after propofol sedation is prolonged in the elderly. Can J Anaesth. 2002; 49(9):927-31. DOI: 10.1007/BF03016876. View

11.

Yli-Hankala A, Vakkuri A, Annila P, KORTTILA K . EEG bispectral index monitoring in sevoflurane or propofol anaesthesia: analysis of direct costs and immediate recovery. Acta Anaesthesiol Scand. 1999; 43(5):545-9. DOI: 10.1034/j.1399-6576.1999.430510.x. View

12.

Gupta A, Kullander M, Ekberg K, Lennmarken C . Assessment of recovery following day-case arthroscopy. A comparison between propofol and isoflurane-based anaesthesia. Anaesthesia. 1995; 50(11):937-42. DOI: 10.1111/j.1365-2044.1995.tb05923.x. View

13.

Gaudio A, Ciritella P, Perrotta F, Puopolo M, Lauta E, Mastronardi P . Remifentanil vs fentanyl with a target controlled propofol infusion in patients undergoing craniotomy for supratentorial lesions. Minerva Anestesiol. 2006; 72(5):309-19. View

14.

LARSEN B, Seitz A, Larsen R . Recovery of cognitive function after remifentanil-propofol anesthesia: a comparison with desflurane and sevoflurane anesthesia. Anesth Analg. 2000; 90(1):168-74. DOI: 10.1097/00000539-200001000-00035. View

15.

Veselis R, Reinsel R, Feshchenko V, Wronski M, Dnistrian A, Dutchers S . Impaired memory and behavioral performance with fentanyl at low plasma concentrations. Anesth Analg. 1994; 79(5):952-60. DOI: 10.1213/00000539-199411000-00023. View

16.

Eikaas H, Raeder J . Total intravenous anaesthesia techniques for ambulatory surgery. Curr Opin Anaesthesiol. 2009; 22(6):725-9. DOI: 10.1097/ACO.0b013e3283310f6b. View

17.

Dressler I, Fritzsche T, Cortina K, Pragst F, Spies C, Rundshagen I . Psychomotor dysfunction after remifentanil/propofol anaesthesia. Eur J Anaesthesiol. 2006; 24(4):347-54. DOI: 10.1017/S0265021506001530. View

18.

Lacombe G, Leake J, Clokie C, Haas D . Comparison of remifentanil with fentanyl for deep sedation in oral surgery. J Oral Maxillofac Surg. 2006; 64(2):215-22. DOI: 10.1016/j.joms.2005.10.026. View

19.

Westmoreland C, Hoke J, Sebel P, HUG Jr C, Muir K . Pharmacokinetics of remifentanil (GI87084B) and its major metabolite (GI90291) in patients undergoing elective inpatient surgery. Anesthesiology. 1993; 79(5):893-903. DOI: 10.1097/00000542-199311000-00005. View

20.

KORTTILA K, Nuotto E, Lichtor J, Ostman P, Apfelbaum J, Rupani G . Clinical recovery and psychomotor function after brief anesthesia with propofol or thiopental. Anesthesiology. 1992; 76(5):676-81. DOI: 10.1097/00000542-199205000-00003. View