• Yoshihiko Kishi, Hironobu Tanigami, Kiyokazu Kagawa, Yoshimi Asakura, Shunji Sonoda, and Yuki Hiuge.
• Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511.
• Masui. 2010 Aug 1; 59 (8): 989-93.

BackgroundStressful procedures such as intratracheal intubation and direct laryngoscopy in very short operations make anesthetic management for laryngomicrosurgery difficult. This study was conducted to evaluate which anesthetic agent, remifentanil or fentanyl, is suitable in anesthesia for laryngomicrosurgery.MethodsAfter obtaining informed consent prior to the study, 18 patients undergoing elective laryngomicrosurgery were randomly allocated to one of two groups to receive remifentanil (R group) or fentanyl (F group). Patients with ages above 76 years and moderate abnormalities in cardiovascular system or respiratory system were excluded.ResultsAverage infusion rate of remifentanil was 0.24 +/- 0.02 microg x kg(-1) x min(-1) and total infused dose of fentanyl was 0.27 +/- 0.05 mg. Average bispectral index values in both groups were comparable. Cases needing sevoflurane inhalation to control blood pressure were significantly more in F group than in R group. Heart rate was significantly lower in R group than in F group. Duration from the end of operation to responses to verbal commands and extubation was significantly shorter in R group than in F group.ConclusionsRemifentanil provided faster recovery and hemodynamic stability. Therefore, remifentanil seems to be more suitable than fentanyl in anesthesia for laryngomicrosurgery.

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