Comparative Efficacy and Safety of Remifentanil and Fentanyl for Intraoperative Anesthesia

Background: Employing opioids as intraoperative analgesics constitutes a crucial element of perioperative pain management. While ensuring hemodynamic stability and mitigating somatic responses are achievable through deep anesthesia, this approach may engender slow recovery and postoperative nausea and vomiting (PONV). Hence, this study aimed to analyze the efficacy of intravenous opioid anesthetic drugs across both intraoperative and postanesthetic recovery stages to optimize postoperative conditions. Methods: This observational analytical study utilized a retrospective approach, involving patients undergoing elective surgery at Dr. Soetomo General Hospital, Surabaya. Parameters included intraoperative Mean Arterial Pressure (MAP) fluctuations, recovery room duration, requirement for postoperative analgesia, and incidence of PONV. Results: This study included 95 patients, comprising 44 individuals with remifentanil and 51 individuals receiving fentanyl. Significant disparities were noted in various intraoperative hemodynamic parameters, encompassing the highest systolic blood pressure, alterations in blood pressure, MAP fluctuations, lowest heart rate, and heart rate changes (p<0.05). Moreover, a noteworthy difference was observed in the duration of recovery room stay (p<0.05), while no significant divergence emerged in the necessity for analgesics or PONV incidence between the two drugs. Conclusion: Administration of continuous intraoperative analgesia with remifentanil elicited a more consistent intraoperative hemodynamic response, resulting in a swifter recovery room duration compared to bolus fentanyl.