Remifentanil Painless Gastroscopy

BACKGROUND: A great quantity of outpatients scheduled for gastroscopy request general anesthesia. A quick recovery from anesthesia is preferred. Remifentanil is characterized by a rapid onset of analgesia and a very short duration of action, which is attributed to its rapid hydrolysis by esterases in blood and tissue. It seems that remifentanil is a better anesthetic for gastroscopy. However, some adverse effects of remifentanil, respiratory depression in particular, cause concerns about its safety in clinical application for gastroscopy. We designed this study to evaluate the efficiency and safety of intravenous remifentanil and propofol for gastroscopy compared with intravenous fentanyl and propofol.METHODS: This is a prospective, randomized and double-blinded clinical trial. 300 ASA class I—II adult patients undergoing gastroscopy were randomly assigned to one of the three modes of administration. A designated nurse prepared all the study drugs. All the anesthetics were diluted with 5% dextrose. Remifentanil and fentanyl were all reconstituted to a concentration of 5mcg.ml^-1. Propofol was diluted to a final concentration of 5mg.ml^-1. 1 ml remifentanil-propofol mixture contains remifentanil 1.5 mcg and propofol 5.0 mg. Two minutes before gastroscopy: fentanyl group received an IV...