Summary Background and aim We investigated the haemodynamic stability and emergence characteristics of isoflurane/nitrous oxide anaesthesia supplemented with remifentanil or fentanyl in patients undergoing carotid endarterectomy. Methods Anaesthesia was induced with propofol (1–2 mg kg−1) and either remifentanil (0.5 µg kg−1) or fentanyl (1 µg kg−1), followed by an infusion of remifentanil (0.2 µg kg−1 min−1) or fentanyl (2 µg kg−1 h−1). Results There were no significant differences between the groups in haemodynamic variables, postoperative pain, nausea or vomiting. After induction there was a significant decrease in mean arterial pressure for both groups (P < 0.001) and a decrease in heart rate (P = 0.001) in the remifentanil group. In both groups these haemodynamic changes continued during maintenance of anaesthesia (P < 0.05). The time to eye opening after surgery was significantly shorter with remifentanil compared with fentanyl (6.62 ± 3.89 vs. 18.0 ± 15.18 min, P = 0.015). Conclusion Remifentanil appears to be a comparable opioid to fentanyl when supplementing isoflurane/nitrous oxide anaesthesia for carotid endarterectomy.
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Doyle et al. (2001) studied this question.