Total intravenöse Anästhesie mit Propofol und Remifentanil

Schmidt, Joachim; Hering, W.; Albrecht, Susanne

doi:10.1007/s00101-004-0787-9

Cited by 17 publications

(5 citation statements)

References 47 publications

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“…Moreover, its context-sensitive half-time is approximately 3 minutes, regardless of the time of injection. Therefore, remifentanil is relatively safe, even after repeated administration or long-term use [ 15 , 17 , 18 ]. It has been reported that continuous administration of low-dose remifentanil in critically ill patients on artificial ventilation can provide adequate stability, breathing, and stable hemodynamic conditions [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Fentanyl versus Remifentanil for Cough Suppression and Recovery after Video-Assisted Thoracic Surgery

et al. 2021

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Background: Various methods have been used to reduce postoperative pain after thoracic surgery. However, these methods may affect the patient's respiratory response and delay recovery from anesthesia. We aimed to evaluate the effects of fentanyl and remifentanil during extubation after video-assisted thoracic surgery (VATS). Methods: This study included 45 randomly-selected male patients who underwent VATS for pneumothorax between July 2011 and August 2012. We divided the participants into 3 groups: the F group, which received a bolus injection of 1.0 µg/kg of fentanyl; the R1 group, which received a 0.04 µg/kg/min remifentanil infusion; and the R2 group, which received a 0.08 µg/kg/min remifentanil infusion. Hemodynamics, pain, cough, consciousness level, and nausea were assessed for each group. Results: The number and severity of coughs were lower in the R1 and R2 groups than in the F group, and there were no differences between the R1 and R2 groups. Respiratory depression and loss of consciousness were not observed in any of the patients, and there were no differences in hemodynamics. Conclusion: In comparison with fentanyl, remifentanil did not result in a wide fluctuation of blood pressure and heart rate upon emergence from general anesthesia. Moreover, remifentanil contributed to cough suppression and postoperative pain control. Remifentanil seems to be a safe and effective analgesic after VATS.

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Section: Discussionmentioning

confidence: 99%

Fentanyl versus Remifentanil for Cough Suppression and Recovery after Video-Assisted Thoracic Surgery

et al. 2021

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“…Ondansetron (8 mg, IV) was injected before general anesthesia induction as prophylaxis for post-operative nausea and vomiting. 31 A standardized general anesthesia protocol was used for all patients (total intravenous anesthesia with propofol and remifentanil 32 , 33 ). All patients received 0.1 mg/kg morphine (IV) 30 min prior to the end of surgery to eliminate remifentanil-induced hyperalgesia.…”

Section: Methodsmentioning

confidence: 99%

Femoral versus Multiple Nerve Blocks for Analgesia after Total Knee Arthroplasty

Stav¹,

Reytman²,

Sevi³

et al. 2017

Rambam Maimonides Med J

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BackgroundThe PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypothesized that preoperative blocking of all four nerves would offer superior analgesia to femoral nerve block alone.MethodsThis is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 107 patients were randomly assigned to one of three groups: a femoral nerve block group, a multiple nerve block group, and a control group. All patients were treated postoperatively using patient-controlled intravenous analgesia with morphine. Pain intensity at rest, during flexion and extension, and morphine consumption were compared between groups over three days.ResultsA total of 90 patients completed the study protocol. Patients who received multiple nerve blocks experienced superior analgesia and had reduced morphine consumption during the postoperative period compared to the other two groups. Pain intensity during flexion was significantly lower in the “blocks” groups versus the control group. Morphine consumption was significantly higher in the control group.ConclusionsPain relief after total knee arthroplasty immediately after surgery and on the first postoperative day was significantly superior in patients who received multiple blocks preoperatively, with morphine consumption significantly lower during this period. A preoperative femoral nerve block alone produced partial and insufficient analgesia immediately after surgery and on the first postoperative day. (Clinical trial registration number (NIH): NCT01303120)

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“…Durch die Entwicklung innovativer Narkosemedikamente hat die total intravenös geführte Allgemeinanästhesie (TIVA) in den letzten Jahren erheblich an Bedeutung gewonnen [12]. Für die endonasale Nasennebenhöhlenchirurgie ergeben sich bei einer TIVA diverse Vorteile, die einerseits in der Vermeidung der Gaskontamination insbesondere des operativen Arbeitsplatzes, andererseits in der günstigen Wirkung auf die Hämodynamik des Patienten liegen.…”

Section: Aktuelle Methoden Der Anästhesieführungunclassified

“…Mit dem ultrakurzwirksamen Opioid Remifentanil steht ein hochpotentes, gut steuerbares Analgetikum zur Verfügung, das nicht nur die schmerzbedingten vegetativen Reflexe unterdrücken, sondern auch über eine zentrale Vagusstimulation [13] den arteriellen Mitteldruck und die Herzfrequenz dosisabhängig senken kann. Das sympathikolytisch wirkende Hypnotikum Propofol [14] weist insbesondere für die Einschlafund die Aufwachphase günstige Eigenschaften auf und senkt zudem die Inzidenz postoperativer Übelkeit und anästhesiebedingten Erbrechens [12].…”

Section: Aktuelle Methoden Der Anästhesieführungunclassified