| ||||||||||||||
|
|
|||||||||||||





*Département Bloc-Anesthésie, Institut Mutualiste Montsouris, Paris, France; and
Département dAnesthésie-Réanimation, Hôpital Pitié-Salpétrière, Paris, France
Address correspondence to Stéphane Mouren, MD, PhD, Département Bloc-Anesthésie, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75674 Paris Cedex 14, France.
We compared the hemodynamic stability during carotid endarterectomy of remifentanil with that of sufentanil anesthesia. Fifty-six patients were randomly assigned into Remifentanil (n = 27) or Sufentanil (n = 29) groups. In the Remifentanil group, IV propacetamol (2 g) and morphine (0.1 mg/kg) were infused 30 min before skin closure. In the Sufentanil group, patients received 2 g propacetamol. Beat-to-beat recordings of systolic arterial blood pressure (SBP) and heart rate (HR) were stored on a computer. The maximum and minimum values of BP and HR after induction, at intubation, during the surgical procedure, and after the operation and the coefficients of variation of SBP and HR were used as indices of hemodynamic stability. The coefficients of variation of SBP and HR were similar in both groups during and after surgery. However, at intubation, maximal SBP was higher in the Sufentanil group (P < 0.05). Decreased propofol doses and isoflurane end-tidal concentrations were used in the Remifentanil group. At recovery, a similar profile of SBP and HR was found in both groups. We conclude that intra- and posthemodynamic stability was similar with remifentanil or sufentanil in patients undergoing carotid endarterectomy. However, remifentanil was more effective for blunting the increase in SBP at intubation without increasing the blood pressure-decreasing effect of induction. Intraoperative remifentanil use was associated with a decreased amount of hypnotic drug administered.
IMPLICATIONS:Beat-to-beat recordings of heart rate and blood pressure in patients undergoing carotid surgery revealed that hemodynamic stability was similar with remifentanil or sufentanil anesthesia both during and after surgery. Remifentanil was more effective in limiting the increase in blood pressure associated with intubation without increasing the blood pressure-lowering effect of induction or the blood pressure response to recovery.
This article has been cited by other articles:
![]() |
A. Bekker, M. Sturaitis, M. Bloom, M. Moric, J. Golfinos, E. Parker, R. Babu, and A. Pitti The Effect of Dexmedetomidine on Perioperative Hemodynamics in Patients Undergoing Craniotomy Anesth. Analg., October 1, 2008; 107(4): 1340 - 1347. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Ahonen, R. Jokela, K. Uutela, and M. Huiku Surgical stress index reflects surgical stress in gynaecological laparoscopic day-case surgery Br. J. Anaesth., April 1, 2007; 98(4): 456 - 461. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. D. Stoneham Editorial I: 'It ain't what you do; it's the way that you do it ...': reducing haemodynamic instability during carotid surgery Br. J. Anaesth., March 1, 2004; 92(3): 321 - 323. [Full Text] [PDF] |
||||
![]() |
G. Godet, M. Reina, M. Raux, J. Amour, V. De Castro, and P. Coriat Anaesthesia for carotid endarterectomy: comparison of hypnotic- and opioid-based techniques{dagger} Br. J. Anaesth., March 1, 2004; 92(3): 329 - 334. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. De Castro, G. Godet, G. Mencia, M. Raux, and P. Coriat Target-Controlled Infusion for Remifentanil in Vascular Patients Improves Hemodynamics and Decreases Remifentanil Requirement Anesth. Analg., January 1, 2003; 96(1): 33 - 38. [Abstract] [Full Text] [PDF] |
||||
|