Asakura Ayako, Mihara Takahiro, Goto Takahisa
Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Japan.
BMC Anesthesiol. 2018 Jul 11;18(1):81. doi: 10.1186/s12871-018-0547-z.
Fentanyl and remifentanil are widely used opioids in surgery, but it has not been evaluated whether the choice of opioids during surgery affects the patients' postoperative quality of recovery. Accordingly, we aim to compare postoperative recovery of fentanyl-based anesthesia with remifentanil-based anesthesia after laparoscopic surgery using the QoR 40 questionnaire (QoR-40).
The study was prospective, randomized, patient and investigator-blinded, controlled, clinical trial. Seventy patients undergoing laparoscopic or retroperitoneoscopic renal or ureteral surgery were recruited and randomized to either fentanyl or remifentanil based anesthesia groups. The primary outcome was the global QoR-40 at 24 h after surgery.
The global median (interquartile range) QoR-40 score was 160 (138-177) in the fentanyl group (n = 32) and 140 (127-166) in the remifentanil group (n = 31). Physical comfort and physical independence, the two out of the five dimensions of the QoR-40, demonstrated significantly high scores in the fentanyl group (P = 0.047 and P = 0.032, respectively).
Although the global QoR is higher in the fentanyl group by 20 points compared with remifentanil group, no significant differences revealed between the groups. Further studies with large numbers of subjects of the same gender are needed.
University Hospital Medical Information Network (UMIN), UMIN000010464 . Registered 10 April 2013.
芬太尼和瑞芬太尼是手术中广泛使用的阿片类药物，但手术期间阿片类药物的选择是否会影响患者术后恢复质量尚未得到评估。因此，我们旨在使用术后恢复质量量表40（QoR - 40）比较腹腔镜手术后基于芬太尼的麻醉与基于瑞芬太尼的麻醉的术后恢复情况。
本研究为前瞻性、随机、患者及研究者双盲、对照临床试验。招募了70例接受腹腔镜或后腹腔镜肾脏或输尿管手术的患者，并将其随机分为基于芬太尼或瑞芬太尼的麻醉组。主要结局指标为术后24小时的整体QoR - 40。
芬太尼组（n = 32）的整体QoR - 40评分中位数（四分位间距）为160（138 - 177），瑞芬太尼组（n = 31）为140（127 - 166）。QoR - 40五个维度中的身体舒适度和身体独立性这两个维度在芬太尼组的得分显著更高（分别为P = 0.047和P = 0.032）。
尽管芬太尼组的整体QoR比瑞芬太尼组高20分，但两组之间未发现显著差异。需要对大量同性别受试者进行进一步研究。
大学医院医学信息网络（UMIN），UMIN000010464。2013年4月10日注册。
