TIVA mit Propofol/Remifentanil oder balancierte Anästhesie mit Sevofluran/Fentanyl bei laparoskopischen Operationen

Juckenhöfel, Stephanie; Feisel, C.; Hj, Schmitt; Biedler, A.

doi:10.1007/s001010050789

Cited by 36 publications

(28 citation statements)

References 16 publications

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“…Inhibitory effects of propofol on the sympathoadrenal system have been documented [7]. The results of some other similar studies are comparable with those obtained in this investigation [7][8][9][10]. In contrast, there are findings which document significantly increased endocrine stress response in a TIVA-propofol group of patients [11,12], or no difference between compared anesthetic regimens [13].…”

Section: Discussionsupporting

confidence: 80%

Serum levels of cortisol and prolactin in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl

et al. 2008

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AbstractThe study was designed to determine pre-, intra-and postoperative serum cortisol and prolactin (PRL) concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and under general balanced anesthesia with isoflurane-fentanyl. The prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to elective low abdominal surgery. Patients were randomly divided into two groups: an experimental group, consisting of 25 ASA I/II (American Society of Anesthesiologists I/II classification) patients treated under TIVA with propofol-fentanyl, and a control group consisting of 25 ASA I/II patients treated under balanced anesthesia with isoflurane-fentanyl. The length of the surgery and the degree of the surgical trauma did not differ significantly between the two anesthesia groups. Blood samples for cortisol and PRL measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery (T2), 2 hours after the surgery (T3), and 24 hours after the surgery (T4). Serum levels of cortisol and PRL were measured using commercially available kits. The results were evaluated with the nonparametric Mann-Whitney test. The serum concentration of cortisol measured at T1 time point in patients treated under TIVA was significantly lower (p=0.04) than that in patients treated under general balanced anesthesia. The average circulating levels of PRL measured at T1, T2 and T3 time points in patients treated under TIVA were significantly lower (p=0.003; p=0.002; p<0.05; respectively) than those in patients treated under balanced anesthesia. The results obtained suggest that the endocrine stress response developed in response to surgery is probably attenuated in patients treated under TIVA with propofol-fentanyl and, thus, that these patients are less stressed in comparison to patients treated under general balanced anesthesia with isoflurane-fentanyl.

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Section: Discussionsupporting

confidence: 80%

Serum levels of cortisol and prolactin in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl

et al. 2008

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“…Observational study on TIVA with TCI propofol and TCI remifentanil for day case gynaecological laparoscopic surgery without muscle relaxants surgery [1]. We evaluated an anaesthetic technique of TIVA using Target Controlled Infusions (TCI) of propofol and remifentanil and controlled ventilation without muscle relaxants in patients undergoing day-case gynaecological laparoscopic surgery.…”

Section: Acknowledgementsmentioning

confidence: 99%

Observational study on TIVA with TCI propofol and TCI remifentanil for day case gynaecological laparoscopic surgery without muscle relaxants

Chandrashekhar¹,

Samaan²

2008

Anaesthesia

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“…Eher selten, bei rund 5% der Patienten, war eine höhere Dosierung über 0,5 mg/kg/min erforderlich. Diese Daten wurden bei einer Vielzahl operativer Eingriffe erhoben und entsprechen den Dosierungsangaben anderer Untersuchungen [12,27,38,58,59,60,71,81,86,88,133,139,171,179]. Sie unterstreichen aber gleichzeitig die Notwendigkeit zur individuellen Remifentanildosierung in Abhängigkeit vom operativen Eingriff und von Patientenzustand und -alter.…”

Section: Intraoperative Dosierungunclassified

“…Der Unterschied zur "konventionellen" Anästhe-sietechnik war überwiegend in der ersten postoperativen Stunde signifikant [11,91]. Danach war meist kein Unterschied mehr feststellbar.Auch die individuelle Zufriedenheit der Patienten mit dem Anästhesieverfahren zeigte häufig keine [96] oder nur unwesentliche Unterschiede [81].…”

Section: Auswahl Des Koanästhetikumsunclassified

Remifentanil

et al. 2003

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Remifentanil is a 4-anilidopiperidine mu-opioid analgesic which is rapidly metabolized by unspecific blood and tissue esterases. According to its unique pharmacokinetic profile, remifentanil-based anaesthesia combines high-dosage opioid analgesia intraoperatively with a rapid and predictable postoperative awakening. When compared with a standard fentanyl-based technique, the use of remifentanil has changed our present anaesthetic regimens. This includes the anaesthesia induction sequence, the choice and dosage of anaesthetics when used as adjuncts to remifentanil, and even more, the proper planning of postoperative pain management. The present paper was designed to review the current knowledge on remifentanil and all aspects of its use in anaesthesiology. In addition, present data on the use of remifentanil for analgesia and sedation of the critically ill patient are summarized.

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TIVA mit Propofol/Remifentanil oder balancierte Anästhesie mit Sevofluran/Fentanyl bei laparoskopischen Operationen

Cited by 36 publications

References 16 publications

Serum levels of cortisol and prolactin in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl

Serum levels of cortisol and prolactin in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl

Observational study on TIVA with TCI propofol and TCI remifentanil for day case gynaecological laparoscopic surgery without muscle relaxants

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