Total intravenous anaesthesia with propofol and remifentanil in paediatric patients: a comparison with a desflurane‐nitrous oxide inhalation anaesthesia

Grundmann, U.; Uth, M.; Eichner, Angelika; Wilhelm, Wolfram; Larsen, Reinhard

doi:10.1111/j.1399-6576.1998.tb05332.x

Cited by 117 publications

(72 citation statements)

References 27 publications

(20 reference statements)

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“…Desflurane has been associated with agitation upon emergence, significantly more so than sevoflurane, halothane, or propofol-remifentanil anesthesia. 6,7 Reported cases of agitation with desflurane have shown clear signs of emergence prior to agitation. Interestingly iv fentanyl 2.5 µg·kg -1 may prevent desflurane-induced agitation.…”

Section: Differential Diagnosismentioning

confidence: 99%

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Roy

Fortier

2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To present and discuss a case of opioid-induced rigidity with low-dose fentanyl during recovery from anesthesia.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 41-yr-old woman underwent laparotomy for total abdominal hysterectomy and bilateral salpingo-oophorectomy under general anesthesia. She received a total of 500 µg of fentanyl by iv intermittent boluses during the three-hour anesthetic. During emergence from anesthesia, while intubated, the patient presented with rigidity. No changes in ventilatory parameters were measured during the episode. The only notable predisposing factor was treatment with venlafexine, an antidepressant that modifies serotonin and norepinephrine levels. She was successfully treated with iv naloxone 20 µg. The rest of the postoperative period was uneventful.

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Section: Differential Diagnosismentioning

confidence: 99%

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Roy

Fortier

2003

Can J Anesth/J Can Anesth

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“…Comparisons of emergence and recovery after propofol and sevoflurane anaesthesia have produced differing results dependent on patients' status, surgical procedures and the analgesics used [2,3]. For total intravenous anaesthesia with propofol and remifentanil, mean (SD) times to tracheal extubation of between 3.8 (1.9) min and 11.0 (3.7) min [4,5] have been reported. Extubation times after sevoflurane anaesthesia have also greatly differed, ranging from 10.0 (3.2) min to 18.0 (17.0) min [6,7].…”

mentioning

confidence: 99%

Propofol/remifentanil vs sevoflurane/remifentanil for long lasting surgical procedures: a randomised controlled trial

et al. 2006

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SummaryWe compared the haemodynamics, emergence and recovery characteristics of total intravenous anaesthesia using propofol ⁄ remifentanil with sevoflurane ⁄ remifentanil anaesthesia, under bispectral index guidance, in 103 patients undergoing surgical procedures lasting > 3.5 h. Time to tracheal extubation was significantly shorter in the propofol group than in the sevoflurane group (mean (SD) 8.3 (3.5) min vs 10.8 (4.6) min, respectively; p = 0.0024), but further recovery was comparable in both groups. There were no significant differences in haemodynamic parameters, intensity of pain or postoperative nausea and vomiting. During and after anaesthesia of comparable depth for long lasting surgical procedures, both propofol ⁄ remifentanil and sevoflurane ⁄ remifentanil enable haemodynamic stability and fast emergence. The shorter time to extubation in the propofol group does not offer a relevant clinical advantage.

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“…Supporting the findings by Aono et al, a study by Kuratini and Oi, examining 4 randomized controlled trials (n=1,252 sevoflurane and n=1,111 halothane) found that children anesthetized with sevoflurane exhibited a greater incidence of ED than those anesthetized with halothane [47]. However, Murray et al, found that premedication with oxycodone increased the incidence of ED in pediatric patients who were anesthetized with halothane compared tosevoflurane [43].…”

Section: Perioperative Risk Factors Inhalation Anestheticsmentioning

confidence: 79%

“…Specifically, there are a significant number of studies linking these anesthetics to a higher incidence of ED [41][42][43][44][45]. It is believed that the low blood solubility characteristic of these newer inhaled anesthetics promote a rapid awakening that concurrently increases susceptibility to ED [42].…”

Section: Perioperative Risk Factors Inhalation Anestheticsmentioning

confidence: 99%

Emergence delirium: a narrative review

Viswanath¹,

Kerner²,

Jean³

et al. 2015

J Anesthesiol Clin Sci

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Emergence delirium (ED) is a post-surgical phenomenon associated with an increase in morbidity, mortality and resource utilization. A systematic review of all current treatment modalities for this condition is imperative given its prevalence during postoperative recovery. This review scrutinizes a number of studies in order to better characterize ED, with particular focus paid to the condition's etiology, associated risk factors, prevention and management. Extensive studies have been conducted on the pediatric population with little attention directed towards the adult and geriatric age groups. Despite this, evidence-based protocols for the management of this condition are still lacking for all age groups. In order to ensure cost effective management and improved safety outcomes for ED, future research should establish and further improve upon screening protocols to identify at risk patients, in addition to formulating a standardized treatment regimen for perioperative patients at risk. Keywords: Emergence delirium, anesthesia recovery period, anesthetic issues and peri-operative care, perioperative complications, preoperative evaluation and anesthesia risk, complications in the post anesthesia care unit

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Total intravenous anaesthesia with propofol and remifentanil in paediatric patients: a comparison with a desflurane‐nitrous oxide inhalation anaesthesia

Abstract: In children, TIVA with remifentanil and propofol is a well-tolerated anaesthesia method, with a lower peroperative heart rate and less postoperative agitation compared with a desflurane-N2O based anaesthesia.

Cited by 117 publications

References 27 publications

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine

Propofol/remifentanil vs sevoflurane/remifentanil for long lasting surgical procedures: a randomised controlled trial

Emergence delirium: a narrative review

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