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Psychomotor Functioning: Comparison of Patients Recovering From General Anesthesia With Remifentanil and a Volatile Anesthetic Versus Fentanyl and a Volatile Anesthetic

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Technical Report

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Uniformed Services University Of The Health Sciences Bethesda United States

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A new opioid, remifentanil, recently gained approval for clinical use by the Food and Drug Administration. This has given anesthesia providers another agent with which to conduct anesthesia for both inpatient and outpatient surgery. Remifentanil has markedly different pharmacokinetics from other commonly used opioids. Specifically, remifentanil provides a predictable and rapid termination of action - a potential advantage over other opioids. The purpose of this study was to compare how remifentanil and another more commonly used opioid, fentanyl, affect one aspect of anesthesia recovery - psychomotor functioning. Twenty three subjects were sampled. Subjects received a balanced anesthetic using either remifentanil and a volatile agent, or fentanyl and a volatile agent. The Trieger Dot test was the assessment tool used to assess for baseline and recovery of psychomotor functioning. A test-retest reliability coefficient of 0.76 was obtained. Analysis of data did not reveal significant differences in psychomotor recovery between the two groups. Possible reasons behind this may have been related to the studys design. Due to the short duration of action associated with remifentanil, all subjects who received remifentanil also received other intraoperative opioids. These may have influenced postoperative psychomotor functioning postoperatively. Additionally, variety incase procedure, length, and the amount of anesthesia required may have significantly influenced postoperative psychomotor functioning.

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