Remifentanil and controlled hypotension; comparison with nitroprusside or esmolol during tympanoplasty

Degoute, C. S.; Ray, Marie-J.; Manchón, M.; Dubreuil, C.; Banssillon, V.

doi:10.1007/bf03019809

Cited by 145 publications

(130 citation statements)

References 34 publications

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“…A study in patients undergoing tympanoplasty compared the effects of induced hypotension under air-oxygen and propofol anesthesia with 0.25-0.5 μg/kg/min remifentanil, 0.25 μg/ kg/min sodium nitroprusside (SNP), or 100-300 μg/kg/min esmolol hydrochloride (ESMO) by measuring middle ear blood flow. Remifentanil or SNP elicited a greater decrease in middle ear blood flow than ESMO 2) . However, SNP decreased pH and increased PaCO 2 .…”

Section: Discussionmentioning

confidence: 84%

Propofol-remifentanil is More Effective than Propofol-fentanyl in Decreasing Intraoperative Blood Loss during Sagittal Split Ramus Osteotomy

Handa

Onodera

Honda

et al. 2016

Bull. Tokyo Dent. Coll.

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This study retrospectively compared blood loss during sagittal split ramus osteotomy in patients receiving propofol-remifentanil (R group) and those receiving propofol-fentanyl (F group). All patients underwent sagittal split ramus osteotomy under general anesthesia during the 3-year 4-month period between October 2007 and February 2011 in an operating room at Tokyo Dental College Suidobashi Hospital. Blood loss in the R group was significantly less than that in the F group. Mean arterial pressure and heart rate, measured at 20 and 15 min after tracheal intubation, respectively, were both lower in the R group. No marked change was observed in blood pressure in the R group under general anesthesia, however. Volume of urine was also larger in the R group. The results of this study suggest that remifentanil is effective in reducing intraoperative blood loss during sagittal split ramus osteotomy.

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Section: Discussionmentioning

confidence: 84%

Propofol-remifentanil is More Effective than Propofol-fentanyl in Decreasing Intraoperative Blood Loss during Sagittal Split Ramus Osteotomy

Handa

Onodera

Honda

et al. 2016

Bull. Tokyo Dent. Coll.

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“…The preferred technique is a combination of remifentanil with propofol or an inhalation agent (isoflurane, desflurane, or sevoflurane) (7)(8)(9)(10)(11). Alpha-2 adrenergic agonists (clonidine and dexmedetomidine) have been used successfully as adjuvants, oral premedication, and intravenous infusion during anesthesia to induce controlled hypotension (12)(13)(14)(15)(16)(17)(18)(19)(20). Clonidine is an alpha-2 adrenergic agonist, which has been used as a centrally acting antihypertensive drug.…”

Section: Discussionmentioning

confidence: 99%

Effect of Clonidine Premedication on Blood Loss in Spine Surgery

et al. 2012

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The addition of oral clonidine to anesthetic management of spine surgery offers clinical advantages. Further dose-finding studies in more complicated spine surgeries are warranted. BackgroundSpinal fusion surgery is often associated with major blood loss, which is sometimes significant, requiring the transfusion of blood or blood products (1). Blood loss can be an acute problem not only in major deformity surgery but also in less extensive fusion procedures. DecreasingBackground: Blood loss in spine surgery is an important issue, even though it has been understudied compared with hip and knee arthroplasty. Objectives: In this study, we evaluated the effect of oral clonidine as premedication on blood loss in lumbar spine fusion surgery under anesthesia with propofol and remifentanil. Patients and Methods:In this double-blind, randomized clinical trial, 30 patients who were undergoing lumbar spine posterior fusion surgery due to traumatic fracture were allocated randomly into 2 groups. The study group (clonidine group) received a 200-µg oral clonidine tablet 60-90 minutes before anesthesia, and the control group received placebo at the same time. Induction and maintenance of anesthesia and the mean target arterial pressure for controlled hypotension with remifentanil were the same in the 2 groups. We compared the amount of intraoperative blood loss, dose of remifentanil/ hour administered, need for nitroglycerine to reach the mean target arterial pressure when remifentanil was insufficient, duration of operation, and surgeon's satisfaction of a bloodless field between groups. Results: There was no statistically significant difference between groups in age (P = 0.115), sex (P = 0.439), weight (P = 0.899), operation time (P = 0.2), or American Society of Anesthesiologists physical status score (P = 0.390). Intraoperative blood loss and remifentanil dose administered per hour in the clonidine group were significantly less than in the control group (P = 0.002 and P = 0.001, respectively), but there was no significant difference in surgeon's satisfaction between groups (P = 0.169). Conclusions: As an oral premedication, clonidine can reduce surgical blood loss in lumbar spine posterior fusion surgery, even at the same levels of mean arterial pressure (MAP) with the control group. Its use can be studied in more complicated spine surgeries, such as scoliosis and spinal deformity surgeries.

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“…Tüm cerrahi prosedürlerde olduğu gibi bu olgularda da rutin EKG, noninvaziv kan basıncı ve periferik oksijen satürasyonu monitorize edilir. Operasyon sırasında cerrahi ekip kansız bir cerrahi saha beklemektedir 17,18 . Bu nedenle hipotansif dengeli anestezi sağlanmalıdır.…”

Section: Peroperatif Yönetim Genel Anesteziunclassified

“…Bu nedenle hipotansif dengeli anestezi sağlanmalıdır. Bu amaçla birçok vazoaktif ve anestezik ajanlar kullanılmıştır [17][18][19] . Örneğin; kohlear implantasyon yapılan çocuklarda remifentanil ile remifentanil-sevofluran kombinasyonu kontrollü hipotansiyon oluşturulmuş ve ortalama arter basıncı, kalp atım hızı ve cerrahi sahanın kalitesi (kuru ve kansız ortam) değerlendirilmiştir.…”

Section: Peroperatif Yönetim Genel Anesteziunclassified

Kohlear İmplant Cerrahisi ve Anestezi

Biricik¹

2015

Arşiv Kaynak Tarama Dergisi

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Cochlear implant, converting mechanical sound energy into electrical signal, is a device that can enables to detection of sounds from cochlea. Cochlear implantation is the name of cochlear implants to be placed in the cochlea. This procedure brings up some difficulties in terms of anesthesia and surgery. Both range of patients population and surgical complications make different implantation applications. Besides age group of children who underwent surgery, this procedure can be applied to all age groups. During surgery, anesthesia technics which allow the immobil bloodness field and fascial nerve neuromonitorisation must be performed. During recovery period from surgery, it is important that patient's head movement must be kept slow and controlled for preventing implant replacement. Also in this period, neuromuscular blocking must be fully reversed for fascial nerve examination. In this article, preoperative preparation, anesthetic management and surgical aspects of cochlear implantation surgery were reviewed. Key words: Cochlear implant surgery, cochlear implantation, anesthesia ÖZET Kohlear implant, mekanik ses enerjisini elektrik sinyallerine dönüştürüp, kohleadan seslerin algılanmasını sağlayan elektronik bir cihazdır. Kohlear implantasyon ise kohlear implantın kohleaya yerleştirilmesine verilen isimdir. Bu uygulama beraberinde anestezi ve cerrahi açısından bazı zorluklar getirmektedir. Gerek hasta popülasyonunun yaş aralığı gerek cerrahi komplikasyonlar implantasyon uygulamalarını farklı kılmaktadır. Cerrahi uygulanan yaş grubu genellikle çocuk olmakla birlikte her yaş grubuna işitme rehabilitasyonu amacıyla uygulanabilmektedir. Cerrahi sırasında immobilizasyon yanında kansız bir cerrahi saha ve fasiyal sinirin nöromonitörizasyonuna izin veren anestezi teknikleri uygulanmalıdır. Cerrahiden uyanma döneminde hastanın baş hareketlerinin az ve kontrollü olması implantın yerinden kaymasını önlemek açısından önemlidir. Yine operasyondan uyanma aşamasında

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Remifentanil and controlled hypotension; comparison with nitroprusside or esmolol during tympanoplasty

Cited by 145 publications

References 34 publications

Propofol-remifentanil is More Effective than Propofol-fentanyl in Decreasing Intraoperative Blood Loss during Sagittal Split Ramus Osteotomy

Propofol-remifentanil is More Effective than Propofol-fentanyl in Decreasing Intraoperative Blood Loss during Sagittal Split Ramus Osteotomy

Effect of Clonidine Premedication on Blood Loss in Spine Surgery

Kohlear İmplant Cerrahisi ve Anestezi

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