Does Fentanyl or Remifentanil Provide Better Postoperative Recovery After Laparoscopic Surgery?

A Randomized Controlled Trial

Ayako Asakura; Takahiro Mihara; Takahisa Goto


BMC Anesthesiol. 2018;18(81) 

In This Article


The quality of recovery (QoR) after anesthesia and surgery has become an important clinical endpoint, since most patients are anesthetized safely and recover early after surgery. Quite a few studies have examined what improves postoperative QoR[1–10] and have been giving changes in our clinical practice.

Opioids with a rapid onset and short duration of action such as fentanyl and remifentanil are essential analgesics during surgery for rapid recovery. The greatest feature of remifentanil is its short context sensitive half time (3–4 min) regardless of the time of administration,[11] which allows quick recovery from anesthesia despite a high plasma or effect-site concentration intraoperatively. In consequence, secretion of cortisol due to surgical stress may be suppressed too much during surgery with remifentanil-based anesthesia. As the administration of glucocorticoids before surgery improved the postoperative recovery in laparoscopic cholecystectomy,[1] it's conceivable that fentanyl-based anesthesia might provide better postoperative QoR than remifentanil-based anesthesia. However, no study examined whether the choice of opioids during surgery affects the patients' postoperative QoR.

Therefore, the aim of the current study was to investigate whether fentanyl-based anesthesia provides better postoperative QoR than remifentanil-based anesthesia after laparoscopic surgery. The Quality of Recovery 40 (QoR-40) questionnaire, which is a global measure of postoperative recovery, was used to assess the early postoperative QoR and the 36-Item Short-Form Health Survey (SF-36™) was used to assess the quality of life (QoL) 1 and 3 months after surgery.