The aim of the study was to compare currently used perioperative analgesia with sufentanil to new opioid remifentanil in a set of neurosurgical patients operated on due to intracranial lesion. In a prospective open clinical study we randomized 20 patients in two groups. Ten patients in group S received sufentanil perioperatively (initial rate 0.5 mcg/kg/hr), ten patients in group R received remifentanil (initial rate 0.1 mcg/kg/hr). The doses were adjusted as requested by the patient. Anaesthesiologic management was equal and standard in both groups. We monitored hemodynamic changes perioperatively and postoperatively, time to extubation and adverse effects. We found statistically significant differences (S vs. R) only in time from completion of surgery to extubation (24.2 ± 6.5 min vs 12.2 ± 2.7 min, p < 0.001), in the occurrence of postoperative pain (0 vs. 5, p < 0.05) and postoperative tachycardia (0 vs. 6, p < 0.01). We observed a trend to more frequent occurrence of postoperative nausea and vomiting in R (0 vs. 4, p = 0.09). The average cost of analgesia was 176 CZK in s vs. 528 CZK in R (p < 0.001). In conclusion, we found that perioperative use of remifentanil during intracranial operation does not possess a significant advantage over sufentanil.

        Key words: neuroanaesthesia - remifentanil - sufentanil