Clinical effects of different doses of remifentanil infusion during intracranial surgery ̇Intrakranyal cerrahide farkli dozlarda remifentanil ̇infüzyonunun klinik etkileṙi
Anestezi Dergisi, cilt.11, sa.4, ss.255-259, 2003 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 11 Sayı: 4
- Basım Tarihi: 2003
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.255-259
- Anahtar Kelimeler: Clinical effects, Intracranial surgery, Remifentanil
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Remifentanil is an opioid suggested in the control of acute stress response to surgical operation and early evaluation of neurological status during postoperative period because of its fast, short and easy titratable effects. In this study, we aimed to evaluate the effects of remifentanil on hemodynamic response during acute stress and postoperative recovery in intracranial surgery. Fifty-six patients undergoing elective intracranial surgery were divided into three groups according to remifentanil infusion rate: Group I (0.075 μg kg-1min-1), Group II (0.15 μg kg-1min-1) and Group III (0.25 μg kg-1min-1). Infusion of remifentanil was initiated after induction of anesthesia in all cases. Sevoflurane 1-2 % in air/oxygen was used in the maintenance of anesthesia. Hemodynamic parameters were recorded for every five minutes based on intubation, application of the head holder, scalp incision and craniectomy. Mean arteriel pressure was tried to be kept between 70-110 mmHg with supplemental boluses of remifentanil (0.5 μg kg-1; IV), nitroprusside (100 μg kg-1; IV) or ephedrine (5-10 mg; IV) as needed. Hemodynamic parameters were evaluated by an anesthesiologist at the end of operation (5=excellent, 1=poor) and extubation-orientation times were recorded. Hemodynamic control was superior in Groups II and III compared to Group I (p<0.05). Mean arteriel pressure was kept within target limits in all groups. Supplemental remifentanil bolus doses and frequency of remifentanil dose were higher in Group I than in Group II and III (p<0.05). Extubation-orientation times were not different among the groups. In conclusion, remifentanil infusion doses of 0.15 μg kg-1min-1 and 0.25 μg kg-1min-1 provided better hemodynamic control than 0.075 μg kg-1min-1 in combination with sevoflurane in intracranial interventions.