Sedoanalgésia con Remifentamil vs. Fentanil en Procedimientos Quirúrgicos cortos en el Hospital "Teodoro Maldonado Carbo"

Abstract

The surgical procedures of short duration (<30min) are very safe procedures when performed by qualified personnel, but also can be very stimulating, unpleasant or uncomfortable. The sedoanalgesia for short procedures must tend to the safety, patient satisfaction and rapid recovery without side effects. The use of ultrashort-acting opioid (remifentanil) has been introduced as agent for intravenous analgesia and very little is generally used as a sedative or analgesic indicated for short surgical procedures. Objectives: To evaluate the efficacy sedoanalgésica by comparing remifentanil continuous infusion (group B) vs. IV boluses of fentanyl (group A) in patients undergoing short surgical procedures in the areas of surgery, the Dr. Teodoro Maldonado Carbo Hospital. Methods: We performed a prospective controlled clinical study which compared the administration of remifentanil by continuous infusion and bolus fentanyl in 110 ASA I-II patients who underwent surgical cleansing and SC. We assessed the degree of analgesia (VAS), degree of sedation, variation in BP, HR, RR, SPO2% and side effects. Statistical Analysis: The comparison between groups was performed with Fischer's exact test and Chi2 test. Results: The presence of agitation, which corresponds to Level 1 Ramsay, was more frequent in group A (6 patients) than in group B (2), in the four periods evaluated. With remifentanyl obtained adequate control of pain according to VAS scale of 0 in a 70.91%, while the EVA obtained fentanyl 1-3 (49-09%) and 4-6 (14%). Few side effects found in our study, but were 6 cases of changes in oxygen saturation (below 90%) in both groups A and B and 1 case of respiratory depression, leaving the table without clinical consequences.