Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 2 , Pages 215-222, February 2006

Comparison of Remifentanil With Fentanyl for Deep Sedation in Oral Surgery

The results of this study were originally presented in June 2003 at the International Association of Dental Research Meeting in Göteborg, Sweden.

  • Gabriel F. Lacombe, DMD, MSc(Anesthesia)

      Affiliations

    • Private Practice, Montréal, Canada.
    • ,
  • James L. Leake, DDS, DDPH, MSc (FRCD(C))

      Affiliations

    • Professor and Head of Community Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
    • ,
  • Cameron M.L. Clokie, DDS, PhD (FRCD(C))

      Affiliations

    • Professor and Head of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
    • ,
  • Daniel A. Haas, DDS, PhD (FRCD(C))

      Affiliations

    • Professor and Head of Anesthesia, Chapman Chair in Clinical Sciences, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Haas: Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, Ontario, M5G 1G6, Canada.

Purpose

The aim of this study was to compare recovery for oral surgery patients given a deep sedation regimen of midazolam, propofol, and remifentanil with a standard control of fentanyl in place of remifentanil.

Materials and Methods

This investigation was designed as a randomized, prospective, single-blinded controlled study. Group 1, the control, received midazolam 0.03 mg/kg, fentanyl 1 μg/kg, and propofol initially at 140 μg/kg/min. Group 2 received midazolam 0.03 mg/kg, remifentanil: propofol (1:500) given at an initial propofol infusion rate of 40 μg/kg/min. Outcome measures included time to response to verbal command, Aldrete score = 9, Postanesthesia Discharge Scoring System = 7, and assessment by the Digit Symbol Substitution Test.

Results

Forty-seven subjects were entered in the study. Baseline findings were homogenous between the 2 groups. Subjects in group 2 recovered earlier (P < .005) and required less propofol for both the induction (0.8 ± 0.4 versus 1.2 ± 0.6 mg/kg; mean ± SD, P < .01) and maintenance of deep sedation (46 ± 9 versus 131 ± 17 μg/kg/min; P < .005). There were minor differences in vital signs.

Conclusions

This study demonstrated that this remifentanil regimen provided significantly more rapid recovery and used significantly less propofol compared with the fentanyl regimen.

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 Funding was provided by Abbott Pharmaceutical Canada.

PII: S0278-2391(05)01673-3

doi:10.1016/j.joms.2005.10.026

Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 2 , Pages 215-222, February 2006

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