• P Latham, E Zarate, P F White, R Bossard, C Shi, L S Morse, L K Douning, and L Chi.
• Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 75235-9068, USA.
• J. Cardiothorac. Vasc. Anesth. 2000 Dec 1;14(6):645-51.

ObjectiveTo compare the effects of an intravenous remifentanil infusion plus intrathecal morphine with intravenous sufentanil infusion with respect to intraoperative hemodynamic variables, extubation times, and recovery profiles when administered as part of a desflurane-based fast-track anesthetic regimen for cardiac surgery.DesignA prospective, randomized, nonblinded study.SettingUniversity hospital.ParticipantsForty patients undergoing elective primary coronary artery bypass graft, aortic valve replacement, or mitral valve replacement surgery.InterventionsAfter a standardized anesthetic induction, anesthesia was maintained with a remifentanil infusion, 0.1 microg/kg/min, and desflurane, 3% to 10%, inspired (group I, n = 20) or a sufentanil infusion, 0.3 microg/kg/h, and desflurane, 3% to 10%, inspired (group II, n = 20). Patients receiving remifentanil were administered intrathecal morphine, 8 microg/ kg, for postoperative analgesia.Measurements And Main ResultsBoth anesthetic regimens provided comparable intraoperative hemodynamic stability and similar recovery profiles, with extubation times of 5.1 +/- 4.3 hours (group I) and 5.8 +/- 6.7 hours (group II).ConclusionsUse of remifentanil in combination with intrathecal morphine did not facilitate earlier tracheal extubation or improve intraoperative hemodynamic stability compared with sufentanil alone for fast-track cardiac anesthesia.

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