Out-patient laparoscopy in general anaesthesia with alfentanil and atracurium. A comparison with fentanyl and pancuronium.

The effects of the new intravenous anaesthetic drugs alfentanil (50 micrograms/kg) and atracurium (0.5 mg/kg) on per- and post-operative function in out-patients clinics were compared with fentanyl (5 micrograms/kg) and pancuronium (0.07 mg/kg). Sixty-two healthy female patients submitted for out-patient sterilization by laparoscopy participated in the study. Thirty patients receiving alfentanil and atracurium (the AA-group) had significantly less pain during analgetic injection, less coughing during intubation, and faster and more pronounced muscle relaxation during induction of anaesthesia, compared with 32 patients receiving fentanyl and pancuronium (the FP-group). The AA-group had less adrenocortical stress-response judged by systolic blood pressure and pulse rate during anaesthesia. Reversal of anaesthesia and neuromuscular blockade were performed without differences in awakening parameters between the two groups. The AA-group had a significantly better score on P-deletion test 45 min after reversal of anaesthesia, a better street fitness score in the afternoon after the procedure and a better day-life function score at home in the evening. There was no difference between the groups in postoperative complaints and in function after the day of operation.