Comparison of Remifentanil in Combination with Isoflurane or Propofol for Short-Stay Surgical Procedures

Rowbotham, D. J.; Peacock, J. E.; Jones, R. M.; Speedy, H. M.; Sneyd, J. R.; Morris, R.; Nolan, J. P.; Jolliffe, D. M.; Lang, Gabriel

doi:10.1097/00132586-199904000-00002

Cited by 6 publications

(8 citation statements)

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“…In both groups this difference was statistically significant from 12.5 min on, until the end of the procedure. Mean HR decreased from a baseline of 129 (8) to 118 (12) and 101 (10) b.p.m. in group 0.2 ( P <0.05, for both), and from 132 (13) at baseline to 122 (13) and 112 (12) b.p.m.…”

Section: Resultsmentioning

confidence: 92%

Remifentanil infusion for cardiac catheterization in children with congenital heart disease

Foubert

Reyntjens

Wolf

et al. 2002

Acta Anaesthesiol Scand

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Section: Resultsmentioning

confidence: 92%

Remifentanil infusion for cardiac catheterization in children with congenital heart disease

Foubert

Reyntjens

Wolf

et al. 2002

Acta Anaesthesiol Scand

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“…. Aufgrund der organunabhängigen Metabolisierung und der kurzen kontextsensitiven Halbwertszeit von Remifentanil lässt die Kombination mit einem gut steuerbaren intravenösen Anästhetikum kurze Aufwachzeiten erwarten [27,29]. Der Vergleich von Aufwachzeiten zwischen unterschiedlichen Studien ist oft schwierig, da sowohl die Prämedikation, die intraoperativen Dosierungen und das Studienprotokoll zur Ausleitung (Infusionsstopp bei Ende der Hautnaht vs. Heruntertitrieren vor Hautnaht) Einfluss auf die Aufwachzeiten haben.…”

Section: Datenqualitätunclassified

“…Rowbotham et al untersuchten in einer Multizenterstudie an 25 Patienten das Aufwachverhalten nach einer Narkose mit 6 mg/kg KG/h Propofol und 0,25 µg/kg KG/min Remifentanil vs. einer Narkose mit Isofluran und Remifentanil. Sie fanden für die TIVA eine mittlere Zeit von 7,6 min bis zur Spontanatmung, 9,5 min bis zur Extubation und nur 45 min bis zur Verlegungsfähigkeit aus dem Aufwachraum [27]. Eine mögliche Erklärung für die schnelle Verlegungsfähigkeit ergibt sich aus der mit 6 min deutlich kürzeren Operationsdauer und der fehlenden prä-operativen Prämedikation.…”

Section: Datenqualitätunclassified

Total intravenöse Anästhesie mit Propofol und Remifentanil

2005

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“…Hinsichtlich der Aufwachzeiten ergaben sich bei der TIVA nur Vorteile, wenn gegen Halothan oder Isofluran untersucht wurde. Im Vergleich mit Sevofluran oder Desfluran ergeben sich keine nennenswerten Unterschiede mehr [40,55,67,68,89,99,104,105].…”

Section: Aufwachen Postoperative Phaseunclassified

Total intraven�se An�sthesie

Strauß

Giest

2003

Der Anaesthesist

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Since venous cannulation in children has become easier and extensive experience has been gained with total intravenous anaesthesia (TIVA) in adults, the interest in TIVA for children has recently increased. An intensified sensitivity of the operating room atmosphere to contamination with volatile anaesthetic agents is another important reason to choose intravenous techniques for paediatric anaesthesia. One of the most interesting agents for TIVA in paediatric anaesthesia is propofol. The pharmacokinetic and pharmacodynamic data for modern intravenous drugs is poor. Because the interpatient variability is relatively large, pharmacokinetic data can only provide guidelines for the dosage of propofol. Propofol has a rapid and smooth onset of action and is as easy to titrate in children as in adults. Propofol can be excellently controlled. Severe haemodynamic side-effects are missing in healthy children and plasma is cleared rapidly of propofol by redistribution and metabolism. There is no evidence of significant accumulation, not even after prolonged infusion times. Because propofol has no analgetic properties it must be combined with analgetics or a regional block for all painful procedures. The combination with the ultra-short acting remifentanil is a major advantage, but requires effective analgetic concepts for painful procedures. In comparison the combination of propofol with long acting opioids abolishes some of the favourable properties of propofol. Further studies of the kinetics and dynamics of propofol and other intravenous agents are needed in paediatrics which should focus on age, maturity and severity of illness. The whole importance of the propofol-infusion syndrome has to be cleared up urgently. TIVA has an important significance in paediatric anaesthesia for diagnostic and therapeutic procedures, especially where these have to be repeated. In day-case anaesthesia TIVA has advantages for all short procedures and for ENT and ophthalmic surgery: even after prolonged infusion children have an short recovery time. There is no evidence of agitation or other behavioural disorders after TIVA with propofol in paediatric anaesthesia. Propofol has anti-emetic properties. TIVA with propofol can be combined with regional anaesthesia advantageously to provide long-lasting analgesia after surgery. TIVA with propofol has been used successfully for sedation of spontaneously breathing children for MRI and CT and other procedures with open airways like bronchoscopy or endoscopy. Propofol facilitates endotracheal intubation without the use of muscle relaxants. Of course, in malignant hyperthermia TIVA will continue to be the technique of choice. Nothing is known about awareness under TIVA in paediatric patients. TIVA must be considered by comparison with the volatile agents. The use of ultra-short acting agents may cause problems such as awareness, vagal response, involuntary movements and in some cases slow recovery after prolonged infusion of propofol. But it is not known exactly how often this happens during paediatri...

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Comparison of Remifentanil in Combination with Isoflurane or Propofol for Short-Stay Surgical Procedures

Cited by 6 publications

References 0 publications

Remifentanil infusion for cardiac catheterization in children with congenital heart disease

Remifentanil infusion for cardiac catheterization in children with congenital heart disease

Total intravenöse Anästhesie mit Propofol und Remifentanil

Total intraven�se An�sthesie

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