Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anesthesia (TIVA)

Özköse, Zerrin; Çok, Oya Yalçın; Tuncer, Bilge; Tufekcioglu, Senem; Yardım, S.

doi:10.1016/s0952-8180(01)00368-3

Cited by 49 publications

(31 citation statements)

References 23 publications

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“…Casati and colleagues [8] showed less frequent occurrence of respiratory depression in the remifentanil group compared with another opioid, but Joshi et al [9] reported the opposite. Postoperative rescue analgesic requirements were reported to be higher in the remifentanil group by Ozkose et al [10], but Derrode et al [11] found no difference.…”

mentioning

confidence: 95%

Remifentanil for general anaesthesia: a systematic review

et al. 2007

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SummaryWe performed a quantitative systematic review of randomised, controlled trials that compared remifentanil to short-acting opioids (fentanyl, alfentanil, or sufentanil) for general anaesthesia. Eighty-five trials were identified and these included a total of 13 057 patients. Intra-operatively, remifentanil was associated with clinical signs of deeper analgesia and anaesthesia, such as fewer responses to noxious stimuli (relative risk 0.65, 95% CI 0.48-0.87), more frequent episodes of bradycardia (1.46, 1.04-2.05), more hypotension (1.68, 1.36-2.07) and less hypertension (0.60, 0.46-0.78). Postoperatively, remifentanil was associated with faster recovery (difference in extubation time of )2.03, 9.5% CI, )2.92 to

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confidence: 95%

Remifentanil for general anaesthesia: a systematic review

et al. 2007

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“…Propofol combined with one of the synthetic opioids and a non-polarising neuromuscular transmission blocker has been a widely used approach for total intravenous anaesthesia for many years [8,9]. Target-controlled infusion systems allow for the accurate dosing of propofol and remifentanil for both for the induction and maintenance of anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…One of the negative effects of the pharmacokinetics of remifentanil is the considerably earlier development of postoperative pain, which more frequently requires early postoperative analgesia compared with other opioids [8,14,18,19].…”

Section: Discussionmentioning

confidence: 99%

Zastosowanie sugammadeksu do odwracania bloku nerwowo-mięśniowego wywołanego wekuronium po operacjach wewnątrzczaszkowych

Karwacki¹,

Niewiadomski²,

Rzaska³

2015

Anaesthesiol Intensive Ther

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Background: Total intravenous anaesthesia with propofol and remifentanil is widely used in neuroanaesthesiology and enables the quick recovery and early neurological assessment of patients. The administration of muscle relaxants carries a risk of residual relaxation following surgery. The administration of a suitable dose of sugammadex reverses the neuromuscular block irrespective of its depth and has none of the side effects associated with acetylcholinesterase inhibitors. The aim of the present study was to evaluate the usefulness of sugammadex for the reversal of vecuroniuminduced effects following intracranial surgery. Method: The study involved 38 women who underwent supratentorial tumour removal. These women were randomly divided into two groups. Total intravenous anaesthesia with propofol and remifentanil using target-controlled infusion was administered according to the Schnider and Minto models, respectively. Endotracheal intubation was performed after the target concentrations of propofol and remifentanil reached 4 µg mL -1 and 4 ng mL -1 , respectively. Vecuronium (100 µg kg -1 ) was administered, and no response to TOF stimulation was observed. Relaxation was continued via the continuous infusion of vecuronium (0.8-1.2 µg kg -1 min -1 ) to provide a TOF of 2 throughout the surgery. In group I, neuromuscular conduction was restored with intravenous sugammadex (2 mg kg -1 ), whereas in group II, no reversal agents were administered. Results: The times of the return of spontaneous breathing, extubation, eye opening (both spontaneous and in response to a verbal command) were found to be longer in group II than group I. Conclusion: The use of sugammadex following craniotomy accelerates the achievement of optimal extubation conditions.

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“…Faster recovery and lower postoperative side-effect profile of intravenous (IV) anaesthetics are advantages over inhalation anaesthetics in patients undergoing lumbar laminectomy or discectomy (3). Rapid and safe recovery of TIVA was revealed following lumbar discectomy (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…A dose of 0.1 mcg kg −1 min −1 remifentanil and 0.5 mcg kg −1 min −1 alfentanil were used, and both opioids were found to be associated with rapid recovery. However, remifentanil exhibited faster respiratory recovery and earlier postoperative pain (4). In a study, 0.25 mcg kg −1 min −1 remifentanil was compared with 1 mcg kg −1 min −1 alfentanil, and it was found that remifentanil had a faster recovery period but adequate postoperative analgesia (6).…”

Section: Introductionmentioning

confidence: 99%