%0 Journal Article %T A Comparative Study of Remifentanil/Propofol versus Alfentanil/Propofol for Wake-up Test in Major Spinal Surgery %J Iranian Journal of Medical Sciences %I Shiraz University of Medical Sciences %Z 0253-0716 %A Perviz Kazemi, A. %A Amini, A. %D 2006 %\ 12/01/2006 %V 31 %N 4 %P 196-199 %! A Comparative Study of Remifentanil/Propofol versus Alfentanil/Propofol for Wake-up Test in Major Spinal Surgery %K Surgery %K spinal cord monitoring %K analgesics %K remifentanil %K alfentanil %R %X Background: Early warning of potential damage to spinal cord during major spinal surgery is highly desirable to prevent post-operative neurological deficits. Wake-up test is a simple, safe and reliable method of recognition of such a complication, and has been extensively used in many spinal surgical units. The present study is evaluating the remifentanil, propofol versus alfentanil, propofol as a part of balanced anesthesia for rapid performance of wake-up test during major spinal surgery. Methods: Fifty patients undergoing elective spinal surgery were randomized to receive either remifentanil/propofol (group A) or alfentanil/propofol (group B). Premedicated patients received remifentanil (a loading dose of 2 μg/kg and a continuous infusion of 1 μg/kg/min), or alfentanil (a loading dose of 25 μg/kg and a continuous infusion of 1 μg/kg/min). Propofol was given as a loading dose of 1.5 mg/kg and a continuous infusion of 100 μg/kg/min.The awakening was accomplished by withdrawing propofol and N2O at 20 and 5 minutes before the test, respectively, whereas remifentanil or alfentanil infusion continued through the wake-up period at a rate of 0.02 ug/kg/min. Results: The onset of intra-operative neurological examination in remifentanil/propofol receiving group (4.6±1.4 minutes) was significantly faster than that for alfentanil/propofol receiving group (7.5±1.8 minutes). Conclusion: Combination of remifentanil and propofol induced a balanced anesthesia for intra-operative awakening and provided a faster opportunity for detecting any potential damage that may occur during spinal instrumentation.  %U https://ijms.sums.ac.ir/article_40050_f6e7c8c8416e71949928d8067ead379f.pdf