A comparison of alfentanil, halothane and enflurane for day‐case gynaecological surgery

Abstract

SummarySixty patients received either alfentanil. halothane or enjlurane .for maintenance of anaesthesia during short day-case gynaecological procedures. The alfentanil group recovered more rapid1.v but there wus no difference between haloihane und enflurane in lerms of recovery time. Apnoea and movement during surgery only occurred in the patienis who received al/entanil. The incidence of other side effects was the same in each group, including late subjective feelings of drowsiness and unsteadiness Key wordsAnaesthetics, gases; enflurane, halothane. Anaesrhetics. intravenous; alfentanil.Alfentanil is a relatively new opiate analgesic with rapid onset of action, short duration of effect and apparently little accumulation when given by repeated injections.' These properties would seem to make alfentanil an ideal agent for short procedures. The recovery time and adverse side-effects of alfentanil were therefore compared to those following anaesthesia with enflurane or halothane. MethodsSixty female patients over the age of 16 years and who weighed between 40-90 kg were included in the study. All attended the gynaecology day-case unit for minor procedures which involved dilatation of the cervix but not involving any skin incision.The patients were randomly allocated to three groups and referred to as Group A (alfentanil), Group H (halothane) and Group E (enflurane).Local ethical approval was obtained, and all patients gave informed consent. Each patient received temazepam 20 mg orally I hour pre-operatively as premedication. Group A received alfentanilO.5 mg at induction by slow intravenous injection followed by methohexitone I % 1 ml every 5 seconds until abolition of the eyelash reflex. Anaesthesia was maintained with nitrous oxide and oxygen (70% :30%) together with increments of alfentanilO.2 mg or methohexitone I ml as indicated clinically. Indications for alfentanil increments were taken as: sweating, lacrimation, increased rate and depth of respiration, minor movement, and the anaesthetist's anticipation of surgical dilatation of the cervix. Gross movement was regarded as an indication for further methohexitone. Group H and Group E both received methohexitone I YO at induction at the rate of I ml every 5 seconds until abolition of the eyelash reflex. Anaesthesia was maintained with 70% N,0/30% 0, plus sufficient halothane or enflurane to produce surgical anaesthesia. No further increments of methohexitone were given to either of these groups.Note was made of the time when the first dose of alfentanil or methohexitone was given at induction, the time that surgery commenced, the time that any increments of drugs were given and the time that all anaesthetic gases were switched off.

A Comparison of Alfentanil, Halothane and Enflurane as Supplements for Outpatient Urological Surgery

“…Other authors have also found recovery with alfentanil to be more rapid than with halothane l3 • 15 or enflurane. 12 The results of the Trieger test, which was intended to demonstrate differences in the quality of recovery, were inconclusive. The Trieger test (a form of paper and pencil test) itself is a modification by Newman, Trieger and Miller, of Bender's Motor Gestalt test which was originally used in World War 11 to discover cases of abnormal cerebral function in Army Medical installations, 1 and later as an aid in diagnosis and psychotherapy in children with organic brain damage.…”