Permalink : http://hdl.handle.net/2115/82759

KEYWORDS : Fentanyl;Remifentanil;Hemodynamic Stability;Total Intravenou s Anesthesia;Orthognathic Surgery

Background: The purpose of this retrospective study was to examine whether total intravenous anesthesia (TIVA) with fentanyl-remifentanil has potential hemodynamic advantages over that with fentanyl alone in orthognathic surgery. Methods: The subjects were 42 generally healthy patients who underwent orthognathic surgery under TIVA using propofol and opioids. Nineteen patients received fentanyl alone (F group), and 23 received fentanyl and remifentanil (FR group) as narcotic analgesics. The factors investigated included arterial blood pressure (ABP), heart rate, the lability index (L.I.) of ABP, number of case that required ephedrine and hypotensive anesthesia. The data between the two groups were compared using the Student’s t-test or Fisher’s exact test. Results: The ABP during anesthesia was significantly lower in the FR group than in the F group. The L.I of the ABP in the FR group was significantly lower than in the F group. The total dose of nitroglycerin for hypotensive anesthesia in the FR group was significantly smaller than that in the F group. The number of cases that required ephedrine was significantly higher in the F R group than in the F group, but hypotension that required administration of ephedrine easily improved, and no refractory hypotension was observed. Conclusion: Total intravenous anesthesia with fentanyl-remifentanil provides superior hemodynamic stability without unacceptable changes in the intraoperative ABP