| Hemodynamic differences between propofol-remifentanil and sevoflurane anesthesia for repair of cleft lip and palate in infants. | |
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MedLine Citation:
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PMID: 17184429 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Propofol-remifentanil anesthesia is widely used in adults but few studies are available in infants. We aimed at comparing the hemodynamic effects of propofol-remifentanil vs sevoflurane-fentanyl anesthesia. In addition, we sought to investigate recovery and whether remifentanil induced acute opioid tolerance. METHODS: In total, 39 infants 4-6 months old were prospectively enrolled and randomized to receive either a combination of remifentanil and propofol (n = 17) or a sevoflurane-fentanyl anesthesia (n = 22) for surgical repair of cleft lip and palate. In both groups, sevoflurane was used for induction of anesthesia and fentanyl was administered before tracheal extubation. Mean arterial blood pressure and heart rate were recorded every 5 min after induction. We also recorded time from termination of surgery to tracheal extubation, postoperative behavior and the need for analgesia for the first 24 h after surgery. Postoperative observations were blinded. RESULTS: In the remifentanil-propofol group, the mean arterial blood pressure was higher [58 (51-65) vs 51 (45-55), P = 0.02] and the mean heart rate was lower [111 (108-113) vs 128 (122-143), P < 0.0001]. There were no differences in recovery time or behavior after surgery. In the remifentanil group, a median fentanyl dose of 4 microg x kg(-1) was required to insure a smooth recovery, but there was no difference in morphine consumption during the first 24 h after surgery. CONCLUSIONS: A high-dose remifentanil-propofol infusion was associated with a higher blood pressure and lower heart rate than sevoflurane-fentanyl anesthesia in infants. Postoperative morphine consumption, recovery time and quality were similar. |
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Authors:
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Jacob Steinmetz; Rolf Holm-Knudsen; Martin Kryspin Sørensen; Kirsten Eriksen; Lars S Rasmussen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Paediatric anaesthesia Volume: 17 ISSN: 1155-5645 ISO Abbreviation: Paediatr Anaesth Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2006-12-22 Completed Date: 2007-04-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206575 Medline TA: Paediatr Anaesth Country: France |
Other Details:
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Languages: eng Pagination: 32-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesia, Centre of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark. jacobsteinmetz@dadlnet.dk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia Recovery Period Anesthetics, Combined / adverse effects, pharmacology Anesthetics, Inhalation / adverse effects, pharmacology Anesthetics, Intravenous / adverse effects, pharmacology Blood Pressure / drug effects* Cleft Lip / surgery Cleft Palate / surgery Dose-Response Relationship, Drug Female Heart Rate / drug effects* Humans Infant Intubation, Intratracheal / methods Male Methyl Ethers / adverse effects, pharmacology* Mouth Abnormalities / surgery* Piperidines / adverse effects, pharmacology* Propofol / adverse effects, pharmacology* Prospective Studies Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 0/Piperidines; 132875-61-7/remifentanil; 2078-54-8/Propofol; 28523-86-6/sevoflurane |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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