Comparison of hemodynamic effects and recovery profiles of esmolol and remifentanil in craniotomy operations [Krani̇yotomi̇lerde esmolol ve remi̇fentani̇li̇n hemodi̇nami̇k etki̇leri̇ni̇n ve derlenme özelli̇kleri̇ni̇n karşilaştirilmasi]

Objective: the aim of this study is to compare esmolol and remifentanil infusions with respect to their effect on perioperative hemodynamic stability,fentanyl consumption and recovery time in craniotomy patients. methods: forty asa i-ii adults scheduled for elective craniotomy were randomised into two groups. group remifentanil received 1 μg kg-1 loading and 0.25-1 μg kg-1 min-1 remifentanil infusion,group esmolol received 500 μg kg-1 loading,100-300 μg kg1 min-1 esmolol infusion. the esmolol and remifentanil infusions were titrated according to target heart rate (hr) and mean arterial pressure (map) (whithin 20% of baseline values). results: hr and map decreased in both groups after the loading dose. the decrease in hr and map was significantly more in group remifentanil after the second hour of surgery. after the extubation the hr and map increased significantly in group remifentanil. the required esmolol infusion rate was 100 (0,06) μg kg-1 min-1 and remifentanil infusion rate was 0,195 (0,06) μg kg-1 min -1 to achieve the targeted hr and map. the number of drug infusion rate changes and fentanyl consumption was higher in group remifentanil conmpared to group esmolol. the recovery was faster in group esmolol compared to group remifentanil (time to aldrete score ≥9,group r: 15,05 (4,45) min,group e: 11,50 (3,12) min p=0,005). [values are mean (standart deviation)]. conclusion: esmolol infusion is superior to remifentanil in providing hemodynamic stability and early recovery in the perioperative period in craniotomy operations. on the other hand,remifentanil infusion is associated with intraoperative and early postoperative complications.