Remifentanil-propofol versus fentanyl-propofol for monitored anesthesia care during hysteroscopy

Ryu, Jin Suk; Kim, Jae Yun; Park, Kum-Suk; Hwan, Sang

doi:10.1016/j.jclinane.2007.12.015

Cited by 33 publications

(31 citation statements)

References 26 publications

(26 reference statements)

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“…In surgeries of short duration, the pharmacokinetic properties of remifentanil provides rapid onset and recovery of its analgesic effect, and it also provides early recovery as it has a lower risk of postoperative respiratory depression. It has been shown that remifentanil infusion decreases the respiratory rate and decreases oxygen saturation [3,14]. In our study, although respiratory depression was seen in five patients in the remifentanil group (16.6%) and in one patient in the ketamine-propofol group (3.3%), no statistically significant difference was observed.…”

Section: Discussioncontrasting

confidence: 64%

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

Öncül

Gaygusuz²,

Yılmaz³

et al. 2016

Anaesthesiol Intensive Ther

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Background: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. Methods: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared. The patient satisfaction was also recorded and the two groups were compared. Results: Age, body mass, ASA status, duration of anaesthesia and type of surgery were found to be similar between groups. The time of the Aldrete score reaching ≥ 9 was found to be shorter in Group R when compared with Group KP (Group R: 4.1 ± 1.9 min, Group K-P: 6.1 ± 2.6 min) (P < 0.05). The incidence of postoperative nausea and vomiting was found to be significantly higher in the remifentanil group (P ≤ 0.05). When the groups were compared in terms of patient satisfaction, in both groups this was found to be similar. Conclusion: Sedation with remifentanil combined with a paracervical block during monitored anaesthesia care provides early recovery with effective sedation and analgesia in hysteroscopy procedures.

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Section: Discussioncontrasting

confidence: 64%

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

Öncül

Gaygusuz²,

Yılmaz³

et al. 2016

Anaesthesiol Intensive Ther

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“…Ryu et al [17] reported that they used propofol and remifentanil and maintained BIS values between 60 and 80 in hysteroscopy patients, and 33% of the patients had respiratory depression who also needed maintenance of open airway and assist ventilation. Olofsen et al [18] discovered the relationship between remifentanil and respiratory depression using a non-steady state model.…”

Section: Discussionmentioning

confidence: 99%

Comparison between monitored anesthesia care with remifentanil under ilioinguinal hypogastric nerve block and spinal anesthesia for herniorrhaphy

Bang

Park

Lee

et al. 2013

Korean J Anesthesiol

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BackgroundThe use of monitored anesthesia care (MAC) as the technique of choice for a variety of invasive or noninvasive procedures is increasing. The purpose of this study to compare the outcomes of two different methods, spinal anesthesia and ilioinguinal-hypogastric nerve block (IHNB) with target concentrated infusion of remifentanil for inguinal herniorrhaphy.MethodsFifty patients were assigned to spinal anesthesia (Group S) or IHNB with MAC group (Group M). In Group M, IHNB was performed and the effect site concentration of remifentanil, starting from 2 ng/ml, was titrated according to the respiratory rate or discomfort, either by increasing or decreasing the dose by 0.3 ng/ml. The groups were compared to assess hemodynamic values, oxygen saturation, bispectral index (BIS), observer assessment alertness/sedation scale (OAA/S), visual analogue scale (VAS) for pain score and patients' and surgeon's satisfaction.ResultsBIS and OAA/S were not significantly different between the two groups. Hemodynamic variables were stable in Group M. Thirteen patients in the same group showed decreased respiratory rate without desaturation, and recovered immediately by encouraging taking deep breaths without the use of assist ventilation. Although VAS in the ward was not significantly different between the two groups, interestingly, patients' and surgeon's satisfaction scores (P = 0.0004, P = 0.004) were higher in Group M. The number of the patients who suffered from urinary retention was higher in Group S (P = 0.0021).ConclusionsIHNB under MAC with remifentanil is a useful method for inguinal herniorrhaphy reflecting hemodynamic stability, fewer side effects and higher satisfaction. This approach can be applied for outpatient surgeries and patients who are unfit for spinal anesthesia or general anesthesia.

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“…Remifentanil provides optimal analgesia with a smooth hemodynamic profile [7], and metabolizes rapidly due to its tissue and blood-nonspecific hydrolysis, which reduces respiratory depression postoperatively regardless of infusion duration [2]. However, respiratory depression caused by propofol and remifentanil sometimes lead to oxygen desaturation during procedures [2].…”

Section: Discussionmentioning

confidence: 99%

“…Propofol is the most commonly used sedative during monitored anesthetic care (MAC) because of its rapid onset, easy titration, and short duration [1]. Remifentanil, an ultra-short acting opioid, has been recently reported to be a suitable adjuvant for MAC with propofol [2]. Although many reports have described the anesthetic management of intrinsic upper central airway obstruction [3], no report has described the use of MAC based on a combination of propofol and remifentanil.…”

Section: Introductionmentioning

confidence: 99%

Monitored Anesthesia Care Using Target-Controlled Infusion with Propofol and Remifentanil in a Patient with Subglottic Stenosis

Choi¹,

Lee²,

Kim³

et al. 2014

J Anesth Clin Res

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Symptomatic airway stenosis requires repeated interventions, such as, dilatation, laser resection, stent implantation, or surgery, and the anesthetic management of upper airway stenosis is complicated due to the risk of respiratory problems while facilitating optimal surgical conditions. The authors described a case of successful monitored anesthetic care with target-controlled propofol and remifentanil infusion during prolonged laser ablation in a patient who developed upper airway stenosis after endotracheal intubation.

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Remifentanil-propofol versus fentanyl-propofol for monitored anesthesia care during hysteroscopy

Cited by 33 publications

References 26 publications

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

Comparison between monitored anesthesia care with remifentanil under ilioinguinal hypogastric nerve block and spinal anesthesia for herniorrhaphy

Monitored Anesthesia Care Using Target-Controlled Infusion with Propofol and Remifentanil in a Patient with Subglottic Stenosis

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