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Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia

BACKGROUND: The goal of this study was to determine the optimal target-controlled concentration of remifentanil combined with desflurane, by using a more widely and decreasing end-tidal concentration of desflurane. METHODS: Ninety ASA I patients, who underwent general anesthesia for elective orthope...

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Autores principales: Shin, Myoung-Keun, Shim, Haeng Seon, Yang, Geun Young, Sung, Woo Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Anesthesiologists 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408510/
https://www.ncbi.nlm.nih.gov/pubmed/22870361
http://dx.doi.org/10.4097/kjae.2012.63.1.25
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author Shin, Myoung-Keun
Shim, Haeng Seon
Yang, Geun Young
Sung, Woo Sung
author_facet Shin, Myoung-Keun
Shim, Haeng Seon
Yang, Geun Young
Sung, Woo Sung
author_sort Shin, Myoung-Keun
collection PubMed
description BACKGROUND: The goal of this study was to determine the optimal target-controlled concentration of remifentanil combined with desflurane, by using a more widely and decreasing end-tidal concentration of desflurane. METHODS: Ninety ASA I patients, who underwent general anesthesia for elective orthopedic or extremity surgeries, were registered and randomly allocated to receive either a target-controlled concentration of 1 ng/ml (group R1), 2 ng/ml (group R2) remifentanil, or desflurane only without remifentanil infusion (group D). Mean arterial pressure (MAP) and heart rate (HR) were recorded at 5-min intervals from after a 10-15 min period of surgical incision to before a 10-min period prior to the end of an operation. End-tidal concentration of desflurane was increased or decreased in proportion to the changes in MAP and HR. If the value of bispectral index (BIS) was from 60-62 for more than 2 min or systolic blood pressure would fall below 90 mmHg, the patient was excluded from the study to prevent a risk of "explicit awareness" and shock. RESULTS: The end-tidal desflurane concentration was lower in the group receiving 1 ng/ml (5.2 ± 0.5 vol%; P < 0.001) and 2 ng/ml remifenanil (4.4 ± 0.5 vol%; P < 0.001) compared to patients in group D (7.9 ± 0.5 vol%). CONCLUSIONS: We recommend the use of 2 ng/ml or less remifentanil combined with desflurane for decreasing concentrations of desflurane without significant side effects, during the "maintenance" phase, and not during the induction phase of general anesthesia.
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spelling pubmed-34085102012-08-06 Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia Shin, Myoung-Keun Shim, Haeng Seon Yang, Geun Young Sung, Woo Sung Korean J Anesthesiol Clinical Research Article BACKGROUND: The goal of this study was to determine the optimal target-controlled concentration of remifentanil combined with desflurane, by using a more widely and decreasing end-tidal concentration of desflurane. METHODS: Ninety ASA I patients, who underwent general anesthesia for elective orthopedic or extremity surgeries, were registered and randomly allocated to receive either a target-controlled concentration of 1 ng/ml (group R1), 2 ng/ml (group R2) remifentanil, or desflurane only without remifentanil infusion (group D). Mean arterial pressure (MAP) and heart rate (HR) were recorded at 5-min intervals from after a 10-15 min period of surgical incision to before a 10-min period prior to the end of an operation. End-tidal concentration of desflurane was increased or decreased in proportion to the changes in MAP and HR. If the value of bispectral index (BIS) was from 60-62 for more than 2 min or systolic blood pressure would fall below 90 mmHg, the patient was excluded from the study to prevent a risk of "explicit awareness" and shock. RESULTS: The end-tidal desflurane concentration was lower in the group receiving 1 ng/ml (5.2 ± 0.5 vol%; P < 0.001) and 2 ng/ml remifenanil (4.4 ± 0.5 vol%; P < 0.001) compared to patients in group D (7.9 ± 0.5 vol%). CONCLUSIONS: We recommend the use of 2 ng/ml or less remifentanil combined with desflurane for decreasing concentrations of desflurane without significant side effects, during the "maintenance" phase, and not during the induction phase of general anesthesia. The Korean Society of Anesthesiologists 2012-07 2012-07-24 /pmc/articles/PMC3408510/ /pubmed/22870361 http://dx.doi.org/10.4097/kjae.2012.63.1.25 Text en Copyright © the Korean Society of Anesthesiologists, 2012 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Shin, Myoung-Keun
Shim, Haeng Seon
Yang, Geun Young
Sung, Woo Sung
Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title_full Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title_fullStr Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title_full_unstemmed Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title_short Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
title_sort effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408510/
https://www.ncbi.nlm.nih.gov/pubmed/22870361
http://dx.doi.org/10.4097/kjae.2012.63.1.25
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