[Remifentanil can reduce intraoperative movement during tympanoplastic surgery--a retrospective analysis].

BACKGROUND: This retrospective study compared remifentanil-sevoflurane anesthesia (RG) with fentanyl-sevoflurane anesthesia (FG) to determine which is accompanied with the lower incidence of intraoperative movement during tympanoplastic surgery under intraoperative facial nerve monitoring. METHODS: We reviewed 91 patients undergoing elective tympanoplastic surgery under intraoperative facial nerve monitoring. All patients were allocated into two groups; RG (48 subjects) and FG (43 subjects). Although vecuronium was given to facilitate endotracheal intubation, additional muscle relaxants were administered in case of intraoperative movement. The intraoperative consumption of sevoflurane, the additional use of vecuronium, incidence of intraoperative movement, and the effect-site concentration of remifentanil or fentanyl were calculated from the anesthetic records. RESULTS: Both the consumption of sevoflurane and the additional use of vecuronium were significantly less in the RG group than in the FG group. Incidence of intraoperative movement in RS was lower than that in FG (RG:FG = 6.2:53.5%, P = 0.002). CONCLUSIONS: According to our data, remifentanil-sevoflurane anesthesia can reduce the incidence of intraoperative movement during tympanoplastic surgery. This lower incidence of intraoperative movement with RG may be owing to the higher effect-site concentration of remifentanil.