Comparison of intraoperative blood loss during spinal surgery using either remifentanil or fentanyl as an adjuvant to general anesthesia

BMC Anesthesiology

Hiroaki Kawano³  Sawa Manabe⁴  Tomomi Matsumoto¹  Eisuke Hamaguchi¹  Michiko Kinoshita³  Fumihiko Tada⁴  Shuzo Oshita² 

[1] Department of Anesthesiology and Clinical Research, National Hospital Organization Zentsuji Hospital, Zentsuji, Japan

[2] Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan

[3] Current affiliation: Department of Anesthesiology, Tokushima Prefectural Central Hospital, Tokushima, Japan

[4] Department of Anesthesiology, Kagawa National Children’s Hospital, Zentsuji, Japan

关键词: General anesthesia;    Spinal surgery;    Fentanyl;    Hemodynamics;    Remifentanil;    Intraoperative blood loss;   

Others  :  816659
DOI  :  10.1186/1471-2253-13-46

 received in 2013-07-06, accepted in 2013-11-21,  发布年份 2013

【 摘 要 】

Background

Remifentanil enhances intraoperative hemodynamic stability, suggesting that it may decrease intraoperative blood loss when included as an adjuvant to general anesthesia. This retrospective study compared intraoperative blood loss during spinal surgery in patients administered either remifentanil or fentanyl as an opioid adjuvant.

Methods

We reviewed clinical and surgical data from 64 consecutive laminoplasty or laminectomy patients treated at National Hospital Organization Zentsuji Hospital between April 2010 and March 2011. Patients received either remifentanil (n = 35) or fentanyl (n = 29) as an opioid analgesic during general anesthesia. In addition to intraoperative blood loss, indices of hemodynamic stability, including heart rate as well as systolic, mean, and diastolic blood pressure (BP), were compared over the entire perioperative period between remifentanil and fentanyl groups.

Results

The remifentanil group exhibited significantly lower intraoperative arterial BP than the fentanyl group. Intraoperative blood loss was also significantly lower in the remifentanil group (125 ± 67 mL vs. 165 ± 82 mL, P = 0.035).

Conclusions

Intraoperative blood loss during spinal surgery was decreased in patients who received remifentanil as an opioid adjuvant, possibly because of lower intraoperative BP. A larger-scale prospective randomized controlled trial is warranted to confirm our results and to test whether remifentanil can decrease intraoperative blood loss during other surgical procedures.

【 授权许可】

   
2013 Kawano et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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