Remifentanil compared with sufentanil during extra-corporeal shock wave lithotripsy with spontaneous ventilation: A doubleblind, randomized study

Abstract

Background. The pharmacokinetic properties of remifentanil may allow a rapid analgesic action during painful procedures and short lasting postoperative respiratory depression. Methods. We carried out a randomized, blind, study in 60 patients to compare remifentanil (continuous i.v. infusion starting at 0.025 μg kg-1 min-1) and sufentanil (i.v. doses of 0.15 μg kg-1) during extra-corporeal shock wave lithotripsy (ESWL). Pain was assessed using a numerical pain scale (0-100), and pain relief was defined as a score ≤30. Respiratory depression was defined as a ventilatory frequency less than 10 breaths min-1 on two occasions or a peripheral oxygen saturation ≤92%, or administration of naloxone. Results. The quality of analgesia was similar in both groups, during and after ESWL. During ESWL, there was no significant difference in respiratory depression in the remifentanil and sufentanil groups (53 vs 73%, NS). The percentage of satisfied patients (73 vs 83%, NS) and satisfied surgeons (97 vs 100%, NS) did not significantly differ between groups. After the procedure patients given remifentanil had less respiratory depression (20 vs 53%, P<0.05) and less nausea and vomiting (3 vs 20%, P<0.05). Conclusion. A continuous i.v. infusion of remifentanil provided comparable analgesia and caused less respiratory depression and nausea and vomiting than i.v. boluses of sufentanil in patients undergoing extra-corporeal shock wave lithotripsy.