Effects of continuous remifentanil administration on intra‐operative subcutaneous tissue oxygen tension

Kabon, Barbara; Kugener, André; Gruenberger, Thomas; Niedermayr, Monika; Fleischmann, Edith; Freissmuth, Michael; Kurz, Andrea

doi:10.1111/j.1365-2044.2007.05228.x

Cited by 8 publications

(2 citation statements)

References 46 publications

(64 reference statements)

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“…Different pain treatment strategies have also shown to influence P sq O 2 levels significantly. Patients receiving epidural analgesia or a continuous infusion of Remifentanil had higher P sq O 2 during abdominal surgery in comparison to an opioid bolus regiment . Additionally, lower pain scores after elective knee surgeries were correlated with higher P sq O 2 .…”

Section: Discussionmentioning

confidence: 92%

Subcutaneous perfusion before and during surgery in obese and nonobese patients

Kaiser

Krejčí

et al. 2015

Wound Repair Regeneration

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Hypoxia at the surgical site impairs wound healing and oxidative killing of microbes. Surgical site infections are more common in obese patients. We hypothesized that subcutaneous oxygen tension (P sq O 2 ) would decrease substantially in both obese and non-obese patients following induction of anesthesia and after surgical incision. We performed a prospective observational study that enrolled obese and non-obese surgical patients and measured serial P sq O 2 before and during surgery. Seven morbidly obese and seven non-obese patients were enrolled. At baseline breathing room air, P sq O 2 values were not significantly different (p 5 0.66) between obese (6.8 kPa) and non-obese (6.5 kPa) patients. The targeted arterial oxygen tension (40 kPa) was successfully achieved in both groups with an expected significant increase in P sq O 2 (obese 16.1 kPa and non-obese 13.4 kPa; p 5 0.001). After induction of anesthesia and endotracheal intubation, P sq O 2 did not change significantly in either cohort in comparison to levels right before induction (obese 15.5, non-obese 13.5 kPa; p 5 0.95), but decreased significantly during surgery (obese 10.1, non-obese 9.3 kPa; p 5 0.01). In both morbidly obese and non-obese patients, P sq O 2 does not decrease appreciably following induction of anesthesia, but decreases markedly (33%) after commencement of surgery. Given the theoretical risks associated with low P sq O 2 , future research should investigate how P sq O 2 can be maintained after surgical incision.

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Section: Discussionmentioning

confidence: 92%

Subcutaneous perfusion before and during surgery in obese and nonobese patients

Kaiser

Krejčí

et al. 2015

Wound Repair Regeneration

View full text Add to dashboard Cite

show abstract

“… 24 , 25 The opioid regimen contributes to optimisation of tissue oxygenation by attenuating = vasoconstriction caused by surgical stimulus and adrenergic response. 26 Studies on anaesthetic/opioid interactions have shown that different combinations of effect-site concentrations of propofol and remifentanil are associated with significant differences in arterial blood pressure. 27 , 28 This supports the reliability of arterial blood pressure as a guide to control a strategy toward a definite point of synergy between unconsciousness and analgesia.…”

Section: Discussionmentioning

confidence: 99%