Comparison of the Effects of Remifentanyl and Dexmedetomidine Infusions on Haemodynamic Parameters and Thyroid Hormones

Özütürk, Bengü; Ersoy, Ayşın; Altan, Aysel; Uygur, Levent Mehmet

doi:10.5152/tjar.2013.39

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Although taking into consideration the different conditions of exposures and the remarkable inter-subject variability, the thyroid is very sensitive to the action of chemical disruptors [43]. Therefore, it cannot be ruled out that physicians, e.g., anesthesiologists and surgeons, employees in rubber and ceramic industry, as well as those involved in the packaging units of a pharmaceutical industry, may be exposed to chemicals, e.g., anesthetics, metals and plasticizers that may mediate hormonal alterations as reported in occupational, epidemiological and experimental settings [44][45][46][47][48][49].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

Leso

Vetrani

Sicignano

et al. 2020

IJERPH

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Thyroid hormones are regulated by the pituitary thyroid stimulating hormone (TSH), whose secretion presents a circadian rhythmicity. Indeed, it is conceivable that shift- and night shift-work, affecting sleep-wake rhythms, may impact thyroid functionality. Therefore, the aim of the present review was to provide an overview on the association between shift- and night shift-work and thyroid hormonal changes and disease development. A systematic review of studies available in PubMed, Scopus, and ISI Web of Science databases was performed. A positive association between night shift-work and increased TSH concentrations was reported by most of the reviewed investigations. Inconclusive evidence was available on thyroid diseases. However, the limited number of studies, the noticeable heterogeneity in the shift-work scheduling, in terms of amount, duration, type of shift- or night shift-work, prevents easily integrating findings and extrapolating definite conclusions. Further investigation seems necessary to better define the relationship between shift schedules and different thyroid outcomes, and possible long-term implications of early functional changes. Overall, this may support the adoption of advanced risk assessment and management strategies aimed to achieve a safer workplace organization and a timely, responsible realization of all the benefits of a 24-h economy.

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Section: Discussionmentioning

confidence: 99%

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

Leso

Vetrani

Sicignano

et al. 2020

IJERPH

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“…In lumbar foraminotomy surgery, patients usually experience more severe postoperative pain than in other common surgeries.4 Dexmedetomidine is an active dextrorotatory isomer of medetomidine and a highly selective α2-adrenoceptor agonist5 commonly used in anesthesia and emergency care. Activation of the receptors inhibits neuronal firing causing sedation, analgesia, hypotension, and bradycardia.6 Termination of pain signals is generally controlled by pre-synaptic activation of the α2-adrenoceptor which inhibits the release of norepinephrine,7 while decrease in blood pressure (BP) and heart rate (HR) is due to the postsynaptic activation of α2-adrenoceptors in the central nervous system which inhibits sympathetic activity.8 It has analgesic, sedative, and anesthetic sparing effect along with cardiovascular stabilizing effects 9,10. It reduces sympathetic tone and attenuates the stress responses to anesthesia and surgery.…”

Section: Introductionmentioning

confidence: 99%

<p>Fentanyl vs fentanyl-dexmedetomidine in lumbar foraminotomy surgery</p>

Hadi¹,

Sbeitan²,

Shakya³

2019

TCRM

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Aim Lumbar foraminotomy surgery requires a potent opioid with short duration and rapid onset of action. In the present study we intended to compare the efficacy of fentanyl alone vs the combination of dexmedetomidine and fentanyl during lumbar foraminotomy surgery. Methods The duration and requirements for first postoperative analgesics, hemodynamic stability, and respective side effects were studied. A prospective, randomized, double blind study of 40 patients (fentanyl group [Fen group] and fentanyl-dexmedetomidine group [Fen-Dex group], n=20 each) scheduled for lumbar foraminotomy surgery under pharmaceutical care intervention was carried out. Patients were classified as class I or II, according to the American Society of Anesthesiologists physical status classification. Patients received intraoperative propofol, sevoflurane, atracurium, and either fentanyl loading dose of 1.0 μg/kg and maintenance infusion dose of 0.2 μg/kg/h in both groups. The patients of the Fen group received normal saline (0.9%) placebo, while the patients of the Fen-Dex group received dexmedetomidine infusion (0.5 μg/kg/h) along with the fentanyl infusion. Postoperative morphine doses were given. Hemodynamic stability, pain, postoperative analgesia requirement, side effects of drugs, and other effects were monitored. Results In the Fen-Dex group, the pain score was significantly less than in the Fen group ( p <0.05). The time to first postoperative analgesia request was prolonged in the Fen-Dex group compared to the Fen group. On the other hand, requirement of morphine, and postoperative symptoms and episodes of nausea and vomiting were significantly greater in the Fen group than in the Fen-Dex group ( p <0.05). Conclusion The present study suggests the addition of dexmedetomidine during lumbar foraminotomy surgery at different levels would be beneficial to reduce morphine consumption and any adverse drug reaction.

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Investigation of Effects of Epidural Anaesthesia Combined with General Anaesthesia on the Stress Response in Patients Undergoing Hip and Knee Arthroplasty

Sağlık¹,

Yazicioglu²,

Çiçekler³

et al. 2015

Turk J Anesth Reanim

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Objective: To investigate the effects of general anaesthesia and general+epidural anaesthesia on the stress response which was evaluated with the adrenocorticotrophic hormone (ACTH), cortisol, insulin, and glucose levels and the haemodynamic parameters.Methods: Forty two, American Society of Anesthesiologists physiologic status I-II, patients undergoing hip and knee arthroplasty were randomized into two groups; general anaesthesia (Group G) and general anaesthesia+epidural anaesthesia (Group E). Epidural anaesthesia: patients in Group E received epidural anaesthesia with 0.5% bupivacaine, a lumbar epidural catheter was placed and after achieving sensorial block at T10 dermatome, general anaesthesia was commenced. General anaesthesia was standardized in both groups. Further, plasma ACTH, cortisol, insulin and glucose levels were determined at preoperative=t1, after the surgical incision=t2, postoperative 2 nd hour=t3 and postoperative 24 th hour=t4. Perioperative heart rate, blood pressures, pain scores and morphine consumption were also determined. . The insulin levels were higher compared with the baseline values at t3, and glucose was higher at t3 and t4 in both groups. Haemodynamic parameters were stable in Group E, and pain scores and morphine consumption were higher in Group G than in Group E. Results Conclusion:Our results suggest that general anaesthesia combined with epidural anaesthesia suppressed the stress response, which was evaluated with ACTH, cortisol levels and haemodynamic parameters; however, this method was ineffective to attenuate the increase in glucose and insulin levels.Keywords: ACTH, arthroplasty, epidural anaesthesia, cortisol, insulin, stress response Amaç: Genel anestezi ve genel anestezi ile birlikte uygulanan epidural anestezinin, adrenokortikotropik hormon (ACTH), kortizol, glukoz ve insülin düzeylerinin yanı sıra hemodinamik değişiklikler ile değerlendirilen stres yanıt üzerindeki etkilerinin araştırılmasıdır.Yöntemler: Kalça ve diz artroplastisi yapılan, Amerikan Anestezistler Derneği fizyolojik durumu I-II olan, 42 hasta rastgele genel anestezi (Grup G) ve genel anestezi+epidural anestezi (Grup E) gruplarına ayrıldı. Epidural anestezi; Grup E'deki hastalara %0,5 bupivakain ile uygulandı, lomber epidural kateter yerleştirildi. Duyu bloğunun T10 seviyesine ulaştığı tespit edildikten sonra hastalara genel anestezi uygulandı. Genel anestezi; her iki grupta da standardize edildi. Plazma ACTH, kortizol insülin ve glukoz düzeyleri, preoperatif=t1, cerrahi insizyondan sonra=t2, postoperatif 2. saat=t3 ve 24. saat=t4'te ölçüldü. Hastaların perioperatif kalp hızı, kan basınçları ve postoperatif ağrı skorları ve morfin tü-ketimleri tespit edildi. Bulgular: ACTH, Grup G'de, Grup E'den yüksekti [Grup G, t2: 71,4±39,9 pg mL -1 ve t3: 578,6±566,1 pg mL -1, Grup E'de t2: 20,2±16,2 pg mL -1 , t3: 56,3±73,6 pg mL -1 (p<0,001)]. Kortizol, Grup G'de, Grup E'den yüksekti [Grup G, t3: 33 Her iki grupta da insülin postoperatif 24. saatte ve glukoz postoperatif 2 ve 24. saatlerde preoperatif düzeylere ...

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Comparison of the Effects of Remifentanyl and Dexmedetomidine Infusions on Haemodynamic Parameters and Thyroid Hormones

Abstract: We suggest that, both agents suppress the hemodynamic response, decrease the consumption of inhalation agents and cause less change in the levels of thyroid hormones, which can be considered as one of the indicators of endocrine response.

Cited by 3 publications

References 25 publications

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

<p>Fentanyl vs fentanyl-dexmedetomidine in lumbar foraminotomy surgery</p>

Investigation of Effects of Epidural Anaesthesia Combined with General Anaesthesia on the Stress Response in Patients Undergoing Hip and Knee Arthroplasty

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