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British Journal of Anaesthesia, 2002, Vol. 89, No. 4 567-570
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Remifentanil compared with sufentanil during extra-corporeal shock wave lithotripsy with spontaneous ventilation: a double-blind, randomized study

H. Beloeil1, G. Corsia1, P. Coriat1 and B. Riou*,1,2

1 Department of Anaesthesiology and Critical Care and 2 Department of Emergency Medicine and Surgery, Groupe hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie, Paris, France*Corresponding author: Départment d’Anesthésie-Réanimation, Groupe hospitalier Pitié-Salpêtrière, 47 Boulevard de l’Hôpital, F-75651 Paris cedex 13, France

Background. The pharmacokinetic properties of remifentanil may allow a rapid analgesic action during painful procedures and short lasting postoperative respiratory depression.

Methods. We carried out a randomized, blind, study in 60 patients to compare remifentanil (continuous i.v. infusion starting at 0.025 µg kg–1 min–1) and sufentanil (i.v. doses of 0.15 µg kg–1) during extra-corporeal shock wave lithotripsy (ESWL). Pain was assessed using a numerical pain scale (0–100), and pain relief was defined as a score <=30. Respiratory depression was defined as a ventilatory frequency less than10 breaths min–1 on two occasions or a peripheral oxygen saturation <=92%, or administration of naloxone.

Results. The quality of analgesia was similar in both groups, during and after ESWL. During ESWL, there was no significant difference in respiratory depression in the remifentanil and sufentanil groups (53 vs 73%, NS). The percentage of satisfied patients (73 vs 83%, NS) and satisfied surgeons (97 vs 100%, NS) did not significantly differ between groups. After the procedure patients given remifentanil had less respiratory depression (20 vs 53%, P<0.05) and less nausea and vomiting (3 vs 20%, P<0.05).

Conclusion. A continuous i.v. infusion of remifentanil provided comparable analgesia and caused less respiratory depression and nausea and vomiting than i.v. boluses of sufentanil in patients undergoing extra-corporeal shock wave lithotripsy.

Br J Anaesth 2002; 89: 567–70


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