The Effects of The Alfentanil and Remifentanil on Haemodynamic Variables and Postoperative Recovery at Gynaecologic Laparoscopy
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Anaesthetic and surgical developments increase the interest to outpatient surgery. Remifentanil, a short acting opioid, is a good alternative to alfentanil for outpatient surgery. We aimed to compare the effects of the alfentanil and remifentanil on haemodynamic variables, postoperative recovery and complication incidence during desflurane used at gynaecologic laparoscopic procedures. Fourty-two patients were included to the study after approval by local ethic committee. After anaesthesia induction was performed by 2 mg kg -1 propofol and 0.1 mg kg-1 vecuronium, the patients were randomly allocated into two groups. In alfentanil group (group A), alfentanil was received 15 ?g kg-1 bolus followed by 1 ?g kg dk -1 until incision and then continued 0.5 ?g kg dk-1. In remifentanil group (group R), remifentanil was received 1 ?g kg -1 bolus followed by 0.5 ?g kg dk-1 until incision and then continued 0.25 ?g kg dk-1. Anaesthesia was maintained with desflurane 3-5 % volume with 40 % oxygen in air. Mechanical ventilation was adjusted to achieve ETCO2 pressure of 35-40 mmHg. Mean arterial pressure (MAP), heart rate (HR) and SpO2 were recorded 10 min intervals during operation and 15 min intervals for postoperative 90 min period. End of the operation, the times of spontaneous ventilation, eye opening, extubation and orientation, and visual analogue scores (VAS), time for Aldrete score >8, first analgesic used and vomiting-nausea were recorded. There were no significant differences in recovery profiles and complications between two groups. All MAP values and HR at the time of 10th, 20th, 30th min, before and after extubation were significantly higher in group A than the other group. In group A, although MAP values were significantly higher at 40th min, before and after extubation, HR values were significantly lower at 20th, 30th, 40th and 50th min compared with baseline values. In group R, MAP values except 40th min and after extubation were lower compared with baseline values. HR values except after extubation were lower compared with baseline value. VAS was lower significantly at postoperative 15th min in group R. In conclusion, remifentanil is a better choice in gynaecologic laparoscopic procedures for haemodynamic stability in balanced anaesthesia than alfentanil. When remifentanil used, postoperative analgesia should be performed before the end of the operation.
Açıklama
Anahtar Kelimeler
Alfentanil, Outpatient surgery, Postanaesthetic recovery, Remifentanil
Kaynak
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
31
Sayı
4
