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We aimed to compare the haemodynamic and recovery properties of propofol-remifentanil and propofol-alfentanil in patients undergoing intracranial surgery. Forty five patients, aged between 15 to 75 years with ASA physical status I-III were included in this study. Patients were divided randomly into two groups. Anaesthesia induction was provided by intravenous bolus remifentanil (0.5 µg/kg) and propofol (1-1.5 mg/kg) in group I (n=25), whereas intravenous bolus alfentanil (20 µg/kg) and propofol (1-1.5 mg/kg) in group II (n=20) and maintained with propofol (3-7 mg/kg/h)-remifentanil (0.25 µg/kg/min) infusion and N20/02 combination in group I, whereas propofol-alfentanil (1.5 µg/kg/min) infusion and N20/02 combination in group II. Hemodynamic variables were recorded preoperatively, during the induction, following intubation, and during the application of head holder and skin incision. Duration of extubation and awakening time, eye opening, responsing to commands, and side effects were recorded postoperatively. SAP and DAP were similar between two groups during the each study period. HR values were higher in alfentanil group than remifentanil group following the application of head holder (p0.05). We concluded that both propofol-remifentanil and propofol-alfentanil combinations exhibited similar effects on hemodynamical variables and recovery profile in patients undergoing intracranial surgery, however, remifentanil may be superior to alfentanil because of more stable HR variables.

Objective of this study was to compare sixty adult burned patients intermittent bolus administration of remifentanil (2 µg/kg), alfentanil (40 µg/kg) and fentanyl (2 µg/kg) for pain management in burned patients undergoing dressing changes and debridement procedures. Following 0.15 mg/kg IV midazolam, IV remifentanil 2 µg/kg in group I, alfentanil 40 µg/kg in group II and fentanyl 2 µg/kg were applied at 30-60 s. The level of sedation was assessed with a score of 0 = awake, alert to 3 = asleep, unarousable. Discomfort and pain were assessed using visual analog scale (VAS). Side effects were not observed. VAS values were statistically significant lower (p=0.018), in group III than in group I at 5. minutes, whereas no statistically significant difference observed among the groups at 1. and 15. minutes. The level of sedation was statistically significant higher(p=0.002, p=0.036), in group III than in group I and II at 15. min., whereas no statistically significant difference was observed among the groups at 1. and 5. min. Apnea and respiratory depression were not seen in group III whereas 3 patients in group I and 1 patient in group II showed apnea episodes. In conclusion we observed that IV bolus administration of remifentanil (2 µg/kg), alfentanil (40 µg/kg) and fentanyl (2 µg/kg) provided effective analgesia for pain control in burn patients. As it is required frequent dose application and caused apnea, intermittent bolus doses of remifentanil is not thought to be suitable whereas alfentanil and fentanyl can used safely for long-term therapeutic procedures in burn patients.

In this study, we aimed to research the effect of intranasal alfentanil administration for premedication, in children. Thirty pediatric patients, 1 to 11 aged, were included in this study. All the patients were taken in preoperative room 30 minutes before the operations. Systolic arterial blood pressure (SBP), heart rate (HR), respiratory rate (RR) and SpO2 were recorded before intranasal alfentanil application. Alfentanil 20 µg/kg was applied intranasally. Using preoperative activity, anxiety and response to face mask scores, the effectiveness of premedication was assessed. All score systems and SBP, HR, SpO2, RR were remeasured at 10th 20th and 30th minutes following intranasal application. There were no differences in SBP, SpO2 and RR compared to initial values after measurements intervals. HR decreased at 10th 20th and 30th minutes following alfentanil application, compared with control value. We did not observe any complication related to intranasal application. We concluded that intranasal alfentanil administration was well tolerated by the patients and evaluated to be an effective and safe method for premedication in children.

This study was undertaken to compare the effects of patient-controlled sedation and analgesia (PCSA) with propofol-alfentanil and patient-controlled analgesia with alfentanil on patient comfort during ESWL for renal stones. Thirty patients (ASA I-II) were divided in two groups. Group I received a loading dose of 1 mg/kg of propofol+10 µg/kg of alfentanil. A PCSA dose of 0.25 mg/kg propofol and 5 µg/kg alfentanil with a lock out of 10 minutes was set for self administration by the patient. Group II received PCA with alfentanil, loading dose 10 µg/kg, bolus dose 5 µg/kg and lock out of 10 minutes. Vital signs; HR, SAP, DAP, RR, SaO2; VAS (0-10) and Sedation (4-point scores) were obtained in every 15 minutes during lithotripsy. Time to recovery and discharge, acceptability scores and total doses of propofol and alfentanil were determined in both groups. There were no significantly differences between two groups with demographic values, duration of ESWL, amount of shock and vital signs HR, RR and SaO2. Only SAP was significantly decreased in PCSA group just following the induction (p

This study was undertaken to evaluate the effects of patient-controlled analgesia (PCA) with alfentanil and compare with intermittent IV bolus administration for ESWL. Thirty (ASA I-II) patients undergoing ESWL were divided in two groups. Group I PCA received a loading dose (10 µg/kg IV) and maintenance close (5 µg/kg IV) of alfentanil with a lock out of 10 minutes. Group II received intermittent IV bolus alfentanil (30 µg/kg) initially then 1 mg as necessary to relieve pain. Vital signs; HR, SAP, DAP, RR, SaO2; Visual analogue pain scores (VAS) and Comfort Scores were obtained in every 15 minutes during lithotripsy. Time to recovery and discharge, acceptability scores and amount of alfentanil received were determined in both group. There were no significantly differences between the two groups with demographic values, duration of ESWL and vital signs. VAS and comfort scores were insignificantly lower in PCA group (p>0.05). No adverse effects were obtained in both group. Time to recovery and discharge were significantly shorter and alfentanil requirement was significantly lower in PCA group (p