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- Title
Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia.
- Authors
Shin, Myoung-Keun; Haeng Seon Shim; Geun Young Yang; Woo Sung Sung
- Abstract
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.
- Subjects
GENERAL anesthesia; OPIOID analgesics; ANESTHESIA in orthopedics; SYSTOLIC blood pressure; FLUORINATION
- Publication
Korean Journal of Anesthesiology, 2012, Vol 63, Issue 1, p25
- ISSN
2005-6419
- Publication type
Article
- DOI
10.4097/kjae.2012.63.1.25