Remifentanil-propofol versus fentanyl-propofol for monitored anesthesia care during hysteroscopy

Study Objective: To compare the efficacy of remifentanil-propofol with that of fentanyl-propofol for monitored anesthesia care during hysteroscopy. Design: Prospective, randomized study. Setting: Operating room and postanesthesia care unit of a university hospital. Patients: 30 ASA physical status I and II adult patients undergoing hysteroscopic procedures. Interventions: After propofol infusion, patients received a bolus of remifentanil (group R, 0.5 mu g/kg) or fentanyl (group F, 1 mu g/kg) 4 minutes before starting the procedure and then received a continuous infusion of remifentanil (group R, 0.05 mu g/kg per min) or bolus doses of fentanyl (group F, 0.5 mu g/kg). Measurements and Main Results: Patients in group R had lower pain scores than patients in group F (0-0 vs 0-7, P < 0.05) and more stable blood pressures (74 +/- 15 vs 85 +/- 9 mmHg, P < 0.05) one minute after the start of the procedure. However, no differences were observed in other variables (recovery profiles and satisfaction scores). Conclusion: Remifentanil seems to be a safe and effective analgesic adjunct for monitored anesthesia care of hysteroscopic surgery. (C) 2008 Elsevier Inc. All rights reserved.