A randomised trial comparing sufentanil versus remifentanil for laparoscopic gastroplasty in the morbidly obese patient

Background and objective This prospective, randomised double-blind study compared the effects of target control infusion (TCI) of sufentanil and remifentanil on the quality of recovery and post-operative pain control in morbidly obese patients undergoing laparoscopic gastroplasty. Methods Following institutional Ethics Committee approval and written informed consent, 100 morbidly obese patients were randomised to receive either TCI sufentanil (0.3 ng ml(-1); S-group; N = 50) or TCI remifentanil (3 ng ml(-1); R-group; N = 50) in combination with desflurane (O-2/air mixture: FiO(2), 50%). Quality of recovery was estimated by means of the modified Aldrete score and by the ability to perform psychomotor tests with the same competence post-operatively as pre-operatively. Post-operative pain was evaluated by the quantity of piritramide needed to achieve a visual analogue scale (VAS) less than 3. Statistical analysis was performed using an unpaired Student's t-test, Mann-Whitney U-test and x(2) test, as appropriate. Results Patient and surgical characteristics were similar among groups. In the R-group, time to extubation was significantly shorter, but VAS significantly higher than that in the S-group (P<0.01). Quality of recovery and duration of post-anaesthesia care unit stay were comparable between groups (S-group: 119 perpendicular to 27 min and R-group: 119 perpendicular to 35 min). Piritramide consumption during the first 4 post-operative hours was higher in the R-group than in the S-group [S-group (median, range): 11.5 mg, 5.5-16.0; R-group: 18.0 mg, 14-22, P<0.01], but not later on. Conclusion In the conditions of the present study, although TCI sufentanil resulted in slower awakening than TCI remifentanil, it was associated with a better quality of recovery. Eur J Anaesthesiol 2011; 28: 120-124 Published online 19 November 2010