Comparative effects of remifentanil and fentanyl on inflammatory stress response in mastectomy surgery with general anesthesia: A case series

Abstract

Malignancy associated with chronic inflammation and stress response events by the surgical procedure. The use of an opioid such as remifentanil can decrease stress response that may be measured by leukocyte, neutrophil-to-lymphocyte ratio (NLR), platelet-to -lymphocyte ratio (PLR), mean platelet volume, blood sugar, and C-reactive protein (CRP). This was a randomized, single-blind study, with a total sample of ten patients, and they were divided into two groups: 1.remifentanil group (0.1–0.3 mcg/kg body weight [BW]/min) and fentanyl group (intermittent 0.5–1 mcg/kg BW every 60 min). The patients' blood were collected two times before and 24 h after surgery. Inflammation markers such as total leukocyte value, NLR, PLR, and dan CRP were increased in two groups.Even PLR postoperative remains high in both group, but in remifentanil group was lower than fentanyl group. There were no differences between the two groups, but remifentanil was found better to suppress the postoperative PLR rather than in the fentanyl group.

Keywords

• c-reactive protein
• fentanyl
• mean platelet volume
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• remifentanil