Objectives: to investigate comparatively the effect of remifentanil vs fentanyl
on stress response and postoperative pain in persons with special needs
undergoing day-case dental surgery.
Study Design: forty-six adult patients with cognitive impairment were enrolled
for dental surgery under general anesthesia. Patients in group F (n=23)
received fentanyl 50 μg iv bolus and in group R (n=23) continuous infusion of
remifentanil 0.5-1 μg/kg/min. The investigated parameters were: intraoperative
hemodynamic response, tumor necrosis factor-α, substance-P, melatonin, cortisol
and β-endorphin measurements and postoperative pain scores.
Results: the two analgesics had similar effects on stress response and
postoperative pain scores. However, the use of remifentanil prevented the
intraoperative hemodynamic response.
Conclusions: the choice of the opioid during dental surgery did not affect
stress and inflammatory hormones, although remifentanil may render
intraoperative management of hemodynamic responses easier. Both opioids are
equally efficient for postoperative pain management following dental surgery in
persons with special needs.
Key words: general anesthesia, remifentanil, fentanyl, mentally disabled
persons, dental surgery
General anesthesia , Remifentanil, Fentanil, Mentally disabled persons, Dental surgery