Objective: We háve been using fast-track techniques (alfentanil and remifentanil based) for cardiac anae¬sthesia in our department routinely since 2001. The aim of this study was to compare these two methods. Design: A prospective follow-up study. Setting: Department of Cardiac Surgery, University Hospital Královské Vinohrady, Charles University, Pra-gue. Materials and methods: In the prospective follow-up study, 71 consecutive patients (alfentanil 32, remifenta¬nil 39) undergoing common cardiothoracic procedures were observed during 2006.The following parameters were observed: time to extubation, length of ICU stay, length of stay on ward, incidence of postoperative atrial fibrillation, blood gases, postoperative pain grade (assessed 1 hour after extubation and on 1st post¬operative day on the visual analogue pain scale and the SF McGill questionnaire), analgesic requirements. Results:There were no statistically significant differences in the most of observed parameters. Postope¬rative pain was dependent solely on patients age (p <0.001) and gender (p =0.042). Conclusion: Both methods allow early and safe extubation of patients undergoing cardiothoracic surgery.

        Key words: cardiac anaesthesia - fast-track - alfentanil - remifentanil - pain