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Target-controlled infusion of remifentanil for conscious sedation during spinal anesthesia.

Byun SH, Hwang DY, Hong SW, Kim SO - Korean J Anesthesiol (2011)

Bottom Line: The aim of this study was to define the optimal target concentration of remifentanil which effectively achieves conscious sedation without significant vital sign changes and side effects during spinal anesthesia.Incidence of intraoperative respiratory depression events, post operative nausea and vomiting were significantly higher in group R35 than the other groups.We conclude that the TCI of remifentanil at 3.0 ng/ml produces an effective sedation and anti-anxiety effects without significant side effects during spinal anesthesia.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: The aim of this study was to define the optimal target concentration of remifentanil which effectively achieves conscious sedation without significant vital sign changes and side effects during spinal anesthesia.

Methods: Sixty patients underwent spinal anesthesia with 0.5% hyperbaric bupivacaine (8-16 mg), and were infused with a target controlled infusion (TCI) of remifentanil at 1.0 ng/ml (group R10, n = 15), 2.0 ng/ml (group R20, n = 15), 3.0 ng/ml (group R30, n = 15), and 3.5 ng/ml (group R35, n = 15). Observer's assessment of alertness/sedation (OAA/S) scale, the bispectral index (BIS), anxiety levels and infusion rate of remifentanil were monitored during the operation.

Results: OAA/S scale was significantly lower in groups R30 (3.96) and R35 (3.34) than groups R10 (4.31) and R20 (4.26). Incidence of intraoperative respiratory depression events, post operative nausea and vomiting were significantly higher in group R35 than the other groups. There were no significant differences in BIS, anxiety level and incidences of recall of the operative procedure among the groups.

Conclusions: We conclude that the TCI of remifentanil at 3.0 ng/ml produces an effective sedation and anti-anxiety effects without significant side effects during spinal anesthesia.

No MeSH data available.


Related in: MedlinePlus

Changes of systolic arterial pressure are shown up to 60 min after administration of remifentanil. Data are expressed as mean ± SE. R10, R20, R30 and R35 represent target concentrations of remifentanil 1.0 ng/ml, 2.0 ng/ml, 3.0 ng/ml and 3.5 ng/ml, respectively in each of target controlled infusion groups. *Group R30 was significantly different compared with group R10 (P < 0.05).
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Figure 2: Changes of systolic arterial pressure are shown up to 60 min after administration of remifentanil. Data are expressed as mean ± SE. R10, R20, R30 and R35 represent target concentrations of remifentanil 1.0 ng/ml, 2.0 ng/ml, 3.0 ng/ml and 3.5 ng/ml, respectively in each of target controlled infusion groups. *Group R30 was significantly different compared with group R10 (P < 0.05).

Mentions: With respect to hemodynamic changes during the operation, HR showed no significant differences among the groups (Fig. 1). SAP decreased significantly in group R30 at 40-50 minutes after the induction of anesthesia compared with group R10 (Fig. 2), but DAP showed no significant differences among the groups (Fig. 3).


Target-controlled infusion of remifentanil for conscious sedation during spinal anesthesia.

Byun SH, Hwang DY, Hong SW, Kim SO - Korean J Anesthesiol (2011)

Changes of systolic arterial pressure are shown up to 60 min after administration of remifentanil. Data are expressed as mean ± SE. R10, R20, R30 and R35 represent target concentrations of remifentanil 1.0 ng/ml, 2.0 ng/ml, 3.0 ng/ml and 3.5 ng/ml, respectively in each of target controlled infusion groups. *Group R30 was significantly different compared with group R10 (P < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198178&req=5

Figure 2: Changes of systolic arterial pressure are shown up to 60 min after administration of remifentanil. Data are expressed as mean ± SE. R10, R20, R30 and R35 represent target concentrations of remifentanil 1.0 ng/ml, 2.0 ng/ml, 3.0 ng/ml and 3.5 ng/ml, respectively in each of target controlled infusion groups. *Group R30 was significantly different compared with group R10 (P < 0.05).
Mentions: With respect to hemodynamic changes during the operation, HR showed no significant differences among the groups (Fig. 1). SAP decreased significantly in group R30 at 40-50 minutes after the induction of anesthesia compared with group R10 (Fig. 2), but DAP showed no significant differences among the groups (Fig. 3).

Bottom Line: The aim of this study was to define the optimal target concentration of remifentanil which effectively achieves conscious sedation without significant vital sign changes and side effects during spinal anesthesia.Incidence of intraoperative respiratory depression events, post operative nausea and vomiting were significantly higher in group R35 than the other groups.We conclude that the TCI of remifentanil at 3.0 ng/ml produces an effective sedation and anti-anxiety effects without significant side effects during spinal anesthesia.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: The aim of this study was to define the optimal target concentration of remifentanil which effectively achieves conscious sedation without significant vital sign changes and side effects during spinal anesthesia.

Methods: Sixty patients underwent spinal anesthesia with 0.5% hyperbaric bupivacaine (8-16 mg), and were infused with a target controlled infusion (TCI) of remifentanil at 1.0 ng/ml (group R10, n = 15), 2.0 ng/ml (group R20, n = 15), 3.0 ng/ml (group R30, n = 15), and 3.5 ng/ml (group R35, n = 15). Observer's assessment of alertness/sedation (OAA/S) scale, the bispectral index (BIS), anxiety levels and infusion rate of remifentanil were monitored during the operation.

Results: OAA/S scale was significantly lower in groups R30 (3.96) and R35 (3.34) than groups R10 (4.31) and R20 (4.26). Incidence of intraoperative respiratory depression events, post operative nausea and vomiting were significantly higher in group R35 than the other groups. There were no significant differences in BIS, anxiety level and incidences of recall of the operative procedure among the groups.

Conclusions: We conclude that the TCI of remifentanil at 3.0 ng/ml produces an effective sedation and anti-anxiety effects without significant side effects during spinal anesthesia.

No MeSH data available.


Related in: MedlinePlus