Recovery profile and side effects of remifentanil‐based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy

Grundmann, U.; Silomon, M.; Bach, Friedhelm; Becker, Sven; Bauer, Michael; Larsen, Birgit Furstrand; Kleinschmidt, S.

doi:10.1034/j.1399-6576.2001.045003320.x

Cited by 65 publications

(46 citation statements)

References 28 publications

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“…The random-effect estimate of the treatment effect is (11)(12)(13)(14)(15) are no different from most meta-analyses and are shown to simplify the subsequent paragraphs. The conditions of our sensitivity analysis of time to extubation (see Results) match the conditions of Sidik and Jonkman's Monte-Carlo simulations that compared the performance of DerSimonian and Laird's method to that of restricted maximum likelihood estimation for estimating s. 57 Specifically, the g = 17 values ofd j were sorted in ascending sequence, and the smallest and largest values were trimmed (see Table 3).…”

Section: Meta-analysismentioning

confidence: 99%

Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Wachtel

Dexter

Epstein

et al. 2011

Can J Anesth/J Can Anesth

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Section: Meta-analysismentioning

confidence: 99%

Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Wachtel

Dexter

Epstein

et al. 2011

Can J Anesth/J Can Anesth

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“…There seems to be a need for an overall assessment of the principle of an evidencebased, multimodal regime that combines current effective perioperative pain, PONV and fluid management, in order to address the issues that still cause post-operative problems for laparoscopic cholecystectomy patients and caregivers in spite of these beneficial interventions. Only a limited number of studies have looked at the combined picture of complaints in the immediate post-operative period (10)(11)(12)(13)(14), and from a logistical point of view for the day surgery setting, this deserves special attention.…”

mentioning

confidence: 99%

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Jensen

Kehlet

Lund

2007

Acta Anaesthesiol Scand

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Background: Laparoscopic cholecystectomy is now often an ambulatory procedure, but dependent on short-term postoperative complaints of pain and post-operative nausea and vomiting (PONV). The efficacy of post-anaesthesia care units (PACUs) is therefore important to facilitate return to normal functions. We investigated the feasibility and efficacy of a standardized, evidence-based anaesthesia/analgesic regime to identify residual problems in the early post-operative phase. Methods: One hundred and thirty-four consecutive patients admitted for elective laparoscopic cholecystectomy at Hvidovre University Hospital between 15 March and 30 September 2005 were included in the study. The standardized, evidence-based regime consisted of total intravenous (i.v.) anaesthesia (propofolremifentanil), well-defined fluid therapy, dexamethasone, ketorolac, ondansetron, sufentanil and incisional bupivacaine intraoperatively, and in the PACU on demand (prn) administration of sufentanil, morphine, paracetamol, ondansetron, droperidol, oral fluids and oxygen (if SpO 2 < 93%) with PACU discharge using a modified Aldrete score. Results: Protocol violations were moderate and occurred unsystematically, 8% had medical violations and 10% did not receive the pre-planned fluid amount. Severe PONV was seen in 2%.

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“…It is frequently used in combination with remifentanil since both drugs have been reported to enable rapid emergence from anesthesia and early return to normal activities. 10,15 Until recently, remifentanil was unavailable in Taiwan. However, the duration of emergence from anesthesia has been shown to be significantly shorter with TIVA than with inhalation anesthesia in breast cancer and gynecological laparoscopic surgeries.…”

Section: Discussionmentioning

confidence: 99%

Faster extubation time with more stable hemodynamics during extubation and shorter total surgical suite time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in lengthy lumbar spine surgery

Lin

Lee³

et al. 2016

SPI

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OBJECT Anesthesia techniques can contribute to the reduction of anesthesia-controlled time and may therefore improve operating room efficiency. However, little is known about the difference in anesthesia-controlled time between propofol-based total intravenous anesthesia (TIVA) and desflurane (DES) anesthesia techniques for prolonged lumbar spine surgery under general anesthesia. METHODS A retrospective analysis was conducted using hospital databases to compare the anesthesia-controlled time of lengthy (surgical time > 180 minutes) lumbar spine surgery in patients receiving either TIVA via target-controlled infusion (TCI) with propofol/fentanyl or DES/fentanyl-based anesthesia, between January 2009 and December 2011. A variety of time intervals (surgical time, anesthesia time, extubation time, time in the operating room, postanesthesia care unit [PACU] length of stay, and total surgical suite time) comprising perioperative hemodynamic variables were compared between the 2 anesthesia techniques. RESULTS Data from 581 patients were included in the analysis; 307 patients received TIVA and 274 received DES anesthesia. The extubation time was faster (12.4 ± 5.3 vs 7.0 ± 4.5 minutes, p < 0.001), and the time in operating room and total surgical suite time was shorter in the TIVA group than in the DES group (326.5 ± 57.2 vs 338.4 ± 69.4 minutes, p = 0.025; and 402.6 ± 60.2 vs 414.4 ± 71.7 minutes, p = 0.033, respectively). However, there was no statistically significant difference in PACU length of stay between the groups. Heart rate and mean arterial blood pressure were more stable during extubation in the TIVA group than in the DES group. CONCLUSIONS Utilization of TIVA reduced the mean time to extubation and total surgical suite time by 5.4 minutes and 11.8 minutes, respectively, and produced more stable hemodynamics during extubation compared with the use of DES anesthesia in lengthy lumbar spine surgery.

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Recovery profile and side effects of remifentanil‐based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy

Cited by 65 publications

References 28 publications

Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Meta-analysis of desflurane and propofol average times and variability in times to extubation and following commands

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Faster extubation time with more stable hemodynamics during extubation and shorter total surgical suite time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in lengthy lumbar spine surgery

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