Intravenous remifentanil and propofol for gastroscopy

Xu, Z; Xiao, Wang; Yong, You; Wu, Jun; Zuo, Yun Xia; Xue, Fu Shan; Liu, Jin

doi:10.1016/j.jclinane.2008.03.006

Cited by 24 publications

(15 citation statements)

References 12 publications

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“…With respect to the surgeon satisfaction, remifentanil group significantly had more cooperation with the surgeon. Akcaboy ( 14 ), Xu ( 16 ), also reported that patients receiving remifentanil had more cooperation with the surgeon in relation to the propofol group. Such findings are probably due to the pain relieving effect of this medicine.…”

Section: Discussionmentioning

confidence: 94%

Comparing Remifentanil Versus Propofol Effect on Pain and Homodynamic Change of Patients Undergoing Phacoemulsification With Topical Anesthesia

Aghadoost

Fazel

Fakharian

2013

Iran Red Crescent Med J

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IntroductionThe purpose of this study was to compare remifentanil versus propofol effect on pain and homodynamic in patients undergoing phacoemulsification with topical anesthesia.Materials and MethodsA double blind clinical trial was conducted to research following the approval of the ethical committee research of the university. One hundred volunteer subjects were randomly assigned into two equal groups (n = 50). The subjects in the propofol group received 3mg/kg/hr while the patients in the remifentanil drug received 3 µg/kg/hr of this medication. Phaco time, blood pressure and heart rate before and after surgery, respiratory depression (O2 sat < 90%) and vomiting, pain scores, ophthalmologist satisfaction and demographic data were recorded.ResultsThe results of analysis showed that there were no significant differences between the age, sex, and duration of operation of the two treatment groups. Systolic, diastolic blood pressure and heart rate were significantly lower in the propofol group .The propofol group complained of pain than the remifentanil group (P = 0.001) while the surgeon satisfaction was higher for the remifentanil condition (P = 0.01). No significant differences were found between the two groups with respect to respiratory depression .No patient suffered from nausea and vomiting.ConclusionsThe results of this study indicated that using appropriate dose of remifentanil instead of propofol results in less pain, more stable homodynamic condition, and satisfaction of surgeon without no respiratory depression or perioperative nausea and vomiting.

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Section: Discussionmentioning

confidence: 94%

Comparing Remifentanil Versus Propofol Effect on Pain and Homodynamic Change of Patients Undergoing Phacoemulsification With Topical Anesthesia

Aghadoost

Fazel

Fakharian

2013

Iran Red Crescent Med J

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“…As research progressed, it is reported that the combination of remifentanil and propofol not only can effectively reduce the incidence of propofol-induced pain but also can reduce the dosage of propofol, shorten patients’ recovery time, and enhance patients’ satisfaction in endoscopy [ 32 , 40 ]. However, the usage of remifentanil varies widely in different studies (for instance, a target concentration of about 0.72 to 3.19 ng/mL [ 13 ], a single dose from 0.2 to 0.5 μg/kg [ 14 , 15 ], and a continuous infusion rate of 6 μg·kg − 1 ·h − 1 [ 33 ]). As both propofol and remifentanil may cause some dose-dependent respiratory and cardiovascular depression, leading to hypoxemia and hemodynamic instability [ 40 , 41 ], it is important to have safe and convenient anesthesia depth monitoring to help control anesthetic dose such as remifentanil target concentration during endoscopic therapy.…”

Section: Discussionmentioning

confidence: 99%

Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial

Liu

Yang

et al. 2018

Trials

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BackgroundWith the development of painless diagnosis and treatment, remifentanil, a synthetic opioid agonist, is increasingly used in gastroscopy for its rapid, short-term, and potent analgesic effect. However, the dosage of remifentanil used in endoscopy is unclear. Index of consciousness (IOC) is a new anesthesia depth-monitoring indicator that can be divided into index of consciousness 1 (IOC1) and index of consciousness 2 (IOC2); IOC1 is used for estimating a patient’s sedation state, whereas IOC2 reflects analgesic depth. We hypothesized that combining with IOC1 and IOC2 monitoring may be helpful to identify an optimal remifentanil dosage in gastroscopic polypectomy.MethodsOne hundred twenty patients scheduled for gastroscopic polypectomy were enrolled and were randomly assigned to remifentanil 2 ng/mL (group R2), 4 ng/mL (group R4), or 6 ng/mL (group R6), and 40 cases were in each group. During the anesthesia period, remifentanil was kept at the initial given concentration but propofol was adjusted according to IOC1. The primary outcomes were the dosage of propofol and remifentanil. The secondary outcomes were the variety of IOC1 and IOC2, patients’ awakening time, and peri-operative adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, body movements, hypoxemia, therapy interruption, nausea, vomiting, aspiration, and intra-operative awareness.ResultsWith the increasing dosage of remifentanil, the propofol dosage and patients’ awakening time decreased significantly, the morbidity of hypertension and body movements also declined, but the incidence of hypotension, bradycardia, and hypoxemia rose. In group R2, the value of IOC2 remained above 50 during the treatment. However, IOC2 dropped to below 30 at the beginning of the gastroscopy in group R6, and there was statistical difference in hypoxemia between groups R2 and R6 (P <0.05).ConclusionsWith the help of IOC monitoring, we found that a target concentration of remifentanil 4 ng/mL is comparatively ideal in patients under gastroscopic polypectomy.Trial registrationChinese Clinical Trial Register: ChiCTR-OOD-16009489, on October 19, 2016.

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“…After pre-oxygenation, sedative was administered with sufentanil 3-5 μg over 5 to 10 s and propofol (1% Diprivan™; AstraZeneca Japan, Osaka, Japan) 1.0 mg · kg –1 intravenously. Supplemental doses of 0.5 mg/kg propofol were administered when the patient was conscious or body movement was found [17]. In contrast, no anaesthetics were administered to the patients in the routine group and the patients maintained conscious throughout the procedure.…”

Section: Methodsmentioning

confidence: 99%

Propofol and sufentanil may affect the patients’ sleep quality independently of the surgical stress response: a prospective nonrandomized controlled trial in 1033 patients’ undergone diagnostic upper gastrointestinal endoscopy

et al. 2017

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BackgroundIt is unknown whether sedative per se contributes to the postoperative sleep disturbance. Diagnostic upper gastrointestinal endoscopy (UGE) is a minimally invasive procedure which is not likely to cause tissue trauma and pain. The purpose of this study was to evaluate the sleep quality of patients undergoing routine (without sedative) diagnostic UGE or UGE with sedative, before, 1 week, and 1 month after the procedure.MethodsOne thousand and thirty-three patients undergoing UGE were enrolled. Patients chose sedative or without sedative. Propofol and sufentanil were administered to the sedative group, not allowed for the routine group. The Pittsburgh Sleep Quality Index (PSQI) was measured before, 1 week and 1 month after the procedure.ResultsFive hundred and ten patients were enrolled in the sedative group and 523 in the routine group. One week after the procedure, patients in the sedative group showed significantly higher PSQI scores (worse sleep quality) than the baseline PSQI scores (p < 0.001), but there was no significant change for the routine group in the same period (p = 0.096). One month after the procedure, there was no significant difference in PSQI scores between the two groups compared with the baseline values (p = 0.358 for sedative group, p = 0.161 for routine group). There were also no significant difference in the PSQI scores between the two groups in the entire 1 month follow-up period (p = 0.885).ConclusionsThe sedative group showed impaired sleep quality 1 week after diagnostic UGE. Propofol and sufentanil may independently affect the sleep quality of patients after sedative of diagnostic UGE for only one week.Trial registrationThis study is registered on Chinese Clinical Trial Registry (IDChiCTR-OCH-13003128). Registered 2 April 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0341-3) contains supplementary material, which is available to authorized users.

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Intravenous remifentanil and propofol for gastroscopy

Cited by 24 publications

References 12 publications

Comparing Remifentanil Versus Propofol Effect on Pain and Homodynamic Change of Patients Undergoing Phacoemulsification With Topical Anesthesia

Comparing Remifentanil Versus Propofol Effect on Pain and Homodynamic Change of Patients Undergoing Phacoemulsification With Topical Anesthesia

Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial

Propofol and sufentanil may affect the patients’ sleep quality independently of the surgical stress response: a prospective nonrandomized controlled trial in 1033 patients’ undergone diagnostic upper gastrointestinal endoscopy

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