Effect of Remifentanil on the Recovery Profile After Prolonged Head and Neck Surgery
Status:
Completed
Trial end date:
2013-07-01
Target enrollment:
Participant gender:
Summary
Opioid tolerance in the perioperative period is inevitable especially with ultra-short acting
agents such as remifentanil. Existing evidence had shown that opioid induced hyperalgesia due
to neuroplastic changes in the central as well as peripheral nervous system leads to
sensitization of pro-nociceptive pathways. However there has been a controversy of occurrence
of such tolerance following the use of remifentanil and the quality of recovery as compared
to conventional opioids. The investigators evaluated the occurrence of opioid tolerance and
other significant adverse effects with remifentanil in subjects undergoing head and neck
surgeries. The investigators studied ASA physical status I and II adult subjects undergoing
elective head and neck procedures, under general anesthesia with minimum expected duration of
2 hours. The remifentanil infusion was used in one group and intermittent boluses of morphine
or fentanyl administered in another group. They were evaluated for immediate post-operative
pain by using numerical rating scale (NRS), the opioid consumption, post-operative nausea,
vomiting, other significant adverse effects of remifentanil and the time to discharge from
PACU.