FENTANYL AND SUFENTANYL IN FAST TRACK ANAESTHESIA FOR MAJOR INTRA-ABDOMINAL SURGERY

Background and aim: Major intra-abdominal surgery is estimated to have high costs annually in Italy. In an attempt to decrease surgery costs and improve outcome for patients, fast-track programs have become popular. This is especially due both to the improvement of surgery and to the new anesthetic agents (regarding pharmacokinetic and pharmacodynamic) resulting in better care for patients. The aim of this study was to evaluate two different anesthetic protocols in patients undergoing scheduled anesthesia including the combination of two different opioids (fentanyl or sufentanil) with the same hypnotic and muscle relaxant. Material and Methods: 40 patients, with an American Society of Anesthesiology score (ASA) 3-4 undergoing surgery, were randomly divided in two equal groups. Group F (fentanyl) received 7-10 mcg/kg and propofol, midazolam and cis-atracurium. Group S (sufentanil) received propofol, midazolam, cis-atracurium and sufentanil 1,5-2 mcg/kg. Results: we measured post-operative pain, median ventilation time, time in intensive care unit (ICU) stay, time to hospital discharge, hemodynamics data and overall safety and satisfaction by the patients. Conclusions: our results suggest that both fentanyl and sufentanil can be recommended for fast-track anesthesia. Sufentanil, because of its pharmacokinetics and pharmacodynamics aspects, produce equally rapid extubation, similar stays and similar costs when compared to fentanyl and can be recommended for fast track anesthesia.