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Anesth Analg 2006;102:237-242
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000181287.86811.5C

NEUROSURGICAL ANESTHESIA

Patient Satisfaction with Awake Craniotomy for Tumor Surgery: A Comparison of Remifentanil and Fentanyl in Conjunction with Propofol

Pirjo H. Manninen, MD*, Mrinalini Balki, MD*, Karolinah Lukitto, MD*, and Mark Bernstein, MD{dagger}

Departments of *Anesthesia and {dagger}Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario

Address correspondence to Pirjo Manninen, MD, Department of Anesthesia, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario Canada MST 258. Address e-mail to pirjo.manninen{at}uhn.on.ca.

In this study we compared the effectiveness of the use of remifentanil to fentanyl in conjunction with propofol in providing conscious sedation for awake craniotomy for tumor surgery and to assess patient satisfaction with both techniques. The ability to maintain appropriate levels of sedation, adequate analgesia, and hemodynamic stability was assessed in 50 patients randomized to receive either fentanyl or remifentanil. All complications were documented. Patients were interviewed at 1 h, 4 h, and 24 h after surgery to note their recall of procedure and pain and their overall satisfaction. There were no differences in sedation and pain scores or in hemodynamic and respiratory variables between the two groups. The incidence of intraoperative complications was not different (fentanyl, 14; remifentanil, 16). Respiratory complications occurred in 9 (18%) patients (fentanyl 6, remifentanil 3). The recall and satisfaction scores were not different; 93% of all patients were completely satisfied at all interview times. The use of remifentanil infusion in conjunction with propofol is a good alternative to fentanyl and propofol for conscious sedation for the awake craniotomy and these techniques are both well accepted by the patient.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.