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document
Comparison of remifentanil with fentanyl for deep sedation in oral surgery . PURPOSE The aim of this study was to compare recovery for oral surgery patients given a deep sedation regimen of midazolam , propofol , and remifentanil with a standard control of fentanyl in place of remifentanil . MATERIALS AND METHODS This investigation was designed as a randomized , prospective , single-blinded controlled study . Group 1 , the control , received midazolam 0.03 mg/kg , fentanyl 1 microg/kg , and propofol initially at 140 microg/kg/min . Group 2 received midazolam 0.03 mg/kg , remifentanil : propofol ( 1:500 ) given at an initial propofol infusion rate of 40 microg/kg/min . Outcome measures included time to response to verbal command , Aldrete score = 9 , Postanesthesia Discharge Scoring System = 7 , and assessment by the Digit Symbol Substitution Test . RESULTS Forty-seven subjects were entered in the study . Baseline findings were homogenous between the 2 groups . Subjects in group 2 recovered earlier ( P < .005 ) and required less propofol for both the induction ( 0.8 +/- 0.4 versus 1.2 +/- 0.6 mg/kg ; mean +/- SD , P < .01 ) and maintenance of deep sedation ( 46 +/- 9 versus 131 +/- 17 microg/kg/min ; P < .005 ) . There were minor differences in vital signs . CONCLUSIONS This study demonstrated that this remifentanil regimen provided significantly more rapid recovery and used significantly less propofol compared with the fentanyl regimen .
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Intervention_Pharmacological
remifentanil
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Intervention_Pharmacological
fentanyl
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Intervention_Pharmacological
midazolam , propofol
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Intervention_Pharmacological
remifentanil
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Intervention_Pharmacological
midazolam 0.03 mg/kg
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Intervention_Pharmacological
fentanyl 1 microg/kg
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Intervention_Pharmacological
propofol initially at 140 microg/kg/min .
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Intervention_Pharmacological
midazolam 0.03 mg/kg , remifentanil : propofol ( 1:500 ) given at an initial propofol infusion rate of 40 microg/kg/min .
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
propofol
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Intervention_Pharmacological
fentanyl
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Outcome_Physical
deep sedation
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Outcome_Mental
time to response to verbal command
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Outcome_Physical
Aldrete score
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Outcome_Other
= 9
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Outcome_Other
Postanesthesia Discharge Scoring System = 7
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Outcome_Other
assessment by the Digit Symbol Substitution Test
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Outcome_Physical
induction
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Outcome_Other
maintenance of deep sedation
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Outcome_Other
rapid recovery
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Participant_Condition
oral surgery patients
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Participant_Condition
Forty-seven subjects were entered in the study .