Comparison of the Propofol-Remifentanil and Desflurane-Remifentanil in Target-Controlled Infusion

Objective: Our objective was to examine the clinical properties of two anesthetic regimens, propofol-remifentanil target-controlled infusion (TCI) or desflurane-remifentanil TCI under bispectral index (BIS) guidance during lower abdominal surgery procedures. Methods: Sixty consenting patients who scheduled for lower abdominal surgery were prospectively studied and were included in one of the two groups: propofol-remifentanil group (Group P) or desflurane-remifentanil group (Group D). General anaesthesia was induced with 2 mg kg-1 propofol, 1 µ kg-1 remifentanil and 0.6 mg kg-1 rocuronium injection. After intubation, remifentanil was administered using the TCI device in both groups. The pharmacokinetic model of Minto was used. Group D patients received a 50%–50% oxygenair mixture and 6% desflurane. The Schnider model was selected for the administration of propofol 1% (10 mg/mL) in Group P, and the TCI dose was adjusted to 4/mL-1. The propofol infusion and inspired fraction of desflurane were adjusted to keep BIS value between 40–60. Hemodynamic parameters, time until recovery of spontaneous respiration, eye-opening and tracheal extubation, compliance with verbal commands, duration of anesthesia and surgery and postoperative modified Aldrete scores were recorded for all patients. Results: The heart rate (p=0.006), diastolic arterial pressure (p=0.003) and mean arterial pressure (p

Hedef Kontrollü İnfüzyonda Propofol-Remifentanil ve Desfluran-Remifentanilin Karşılaştırlması

Amaç: Alt karın cerrahisi sırasında bisektral indeks (BIS) rehberliğinde hedef kontollü infüzyon (HKİ) kullanılarak iki anestezik rejimin, propofolremifentanil veya desfluran-remifentanilin klinik özelliklerini incelemektir. Gereç ve Yöntem: Alt karın cerrahisi geçirecek 60 hasta randomize olarak iki gruba ayrıldı: Propofol-remifentanil grup (Grup P) ve desfluran-remifentanil grup (Grup D). Tüm hastalara anestezi indüksiyonu 2 mg kg-1 propofol, 1 µg kg-1 remifentanil ve 0.6 mg kg-1 rokuronyum iv ile sağlandı. Her iki grupta da entübasyon sonrası remifentanil infüzyonu Minto farmokinetik modeline göre HKI cihazıyla uygulandı. Grup D’deki hastalara %50–50 oksijen hava karışımı ve %6 desflurane uygulandı. Grup P’de propofol %1(10 mg/mL) için farmakokinetik model Schnider modeli seçildi ve HKİ ile 4 µ/mL-1 olacak şekilde uygulandı. BIS değeri 40–60 arasında tutulacak şekilde dozlar artırıldı ya da azaltıldı. Tüm hastaların hemodinamik parametreleri, spontan solunumun geri dönme süresi, göz açma süresi, trakeal ekstübasyon süresi, verbal komutlara uyma süresi, anestezi ve cerrahi süresi, ameliyat sonrası Modifiye Aldrete skoru kaydedildi. Bulgular: Operasyon süresince yapılan incelemede kalp atım hızı (p=0.006), diyastolik arter basıncının (p=0.003) ve ortalama arter basıncının (p

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1.1b380

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