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    Comparison of propofol-alfentanil and propofol-remifentanil anaesthesia in percutaneous nephrolithotripsy
    (Cambridge Univ Press, 2005) Cicek, M; Koroglu, A; Demirbilek, S; Teksan, H; Ersoy, MO
    Background and objective: Percutaneous nephrolithotripsy (PCNL) is used for the fragmentation and removal of stones from the renal pelvis and renal calyceal systems. We compared the effects of propofol-alfentanil or propofol-remifentanil anaesthesia on haemodynamics, recovery characteristics and postoperative analgesic requirements during percutaneous nephrolithotripsy. Methods: Thirty non-premedicated patients were randomly allocated to receive either propofol-alfentanil (Group A) or propofol-remifentanil (Group R). The loading dose of the study drug was administered over 60 s (alfentanil 10 mu g kg(-1) or remifentanil 1 mu g kg(-1)) followed by a continuous infusion (alfentanil 15 mu g kg(-1) h(-1) or remifentanil 0.15 mu g kg(-1) min(-1)). Propofol was administered until loss of consciousness and maintained with a continuous infusion of 75 mu g kg(-1) min(-1) in both groups. Atracuriurn was given for endotracheal intubation at a dose of 0.5 mg kg(-1) and maintained with a continuous infusion of 0.4 mg kg(-1) h(-1) Mean arterial pressure heart rate, the total amount of propofol, time of recovery of spontaneous ventilation, extubation and eye opening in response to verbal stimulus and analgesic requirement were recorded. Results: In Group A, mean arterial pressure was higher at the first minute in the prone position, and during skin incision and lithotripsy, and heart rate was higher during skin incision and lithotripsy when compared with Group R (P < 0.05). The total amount of propofol did not differ between groups. Time of recovery of spontaneous ventilation, extubation and eye opening were significantly shorter in Group R than Group A (P < 0.05). Conclusions: Both propofol-remifentanil and propofol-alfentanil anaesthesia provided stable haemodynamics during percutaneous nephrolithotripsy, whereas propofol-remifentanil allowed earlier extubation.
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    Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results
    (Elsevier Sci Ltd, 2005) Koroglu, A; Demirbilek, S; Teksan, H; Sagir, O; But, AK; Ersoy, MO
    Background. We evaluated the sedative, haemodynamic and respiratory effects of dexmedetomidine and compared them with those of midazolam in children undergoing magnetic resonance imaging (MRI) procedures. Methods. Eighty children aged between 1 and 7 yr were randomly allocated to receive sedation with either dexmedetomidine (group D, n=40) or midazolam (group M, n=40). The loading dose of the study drugs was administered for 10 min (dexmedetomidine 1 mu g kg(-1) or midazolam 0.2 mg kg(-1)) followed by continuous infusion (dexmedetomidine 0.5 mu g kg(-1) h(-1) or midazolam 6 mu g kg(-1) min(-1)). Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during MRI. The children who were inadequately sedated were given a single dose of rescue midazolam and/or propofol intravenously. Mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Sp(o2)) and ventilatory frequency (VF) were monitored and recorded during the study. Results. The quality of MRI was significantly better and the rate of adequate sedation was higher in group D than in group M (P < 0.001). In group D, the requirement for rescue drugs was lower and the onset of sedation time was shorter than in group M (P < 0.001). MAP, HR and VF decreased from baseline during sedation in both groups (P < 0.001). Conclusions. Dexmedetomidine provided adequate sedation in most of the children aged 1-7 yr without haemodynamic or respiratory effects during MRI procedures.