JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (12)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Matute, E.
Right arrow Articles by Gilsanz, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Matute, E.
Right arrow Articles by Gilsanz, F.
Anesth Analg 2002;94:1217-1222
© 2002 International Anesthesia Research Society

ANESTHETIC PHARMACOLOGY

An Inhalation Bolus of Sevoflurane Versus an Intravenous Bolus of Remifentanil for Controlling Hemodynamic Responses to Surgical Stress During Major Surgery: A Prospective Randomized Trial

Emilio Matute, MD DEAA, Estíbaliz Alsina, MD, Rosario Roses, MD, Guadalupe Blanc, MD, Concepción Pérez-Hernández, MD, and Fernando Gilsanz, MD PhD

Department of Anesthesiology, Hospital La Princesa, Universidad Autónoma de Madrid, Madrid, Spain

Address correspondence and reprint requests to Emilio Matute, MD, DEAA, Department of Anesthesia, Hospital La Princesa, Calle Diego de León, 62, 28006 Madrid, Spain. Address e-mail to med009569{at}nacom.es

We studied 120 patients scheduled for elective major thoracic or abdominal surgery, randomized into 2 groups: a Sevoflurane group (n = 63) and a Remifentanil group (n = 57). Heart rate (HR) and mean arterial pressure (MAP) are indicative of sympathetic response to surgical stress. A positive response was defined as a 15% increase in the HR and MAP above baseline mea-surements. When a positive response occurred, in the Sevoflurane group we administered a bolus dose of 8% sevoflurane (fresh gas flow 6 L/min) and in the Remifentanil group, an IV bolus dose of remifentanil 1 µg · kg-1 · min-1, which was maintained until MAP and HR returned to baseline measurements (effective bolus). If, after a bolus dose, a decrease in MAP and/or HR of >15% occurred with respect to baseline values, the response was considered to be excessive. The bolus dose was ineffective in 4.8% of the responses in the Sevoflurane group and in 17.8% of the responses in the Remifentanil group (P < 0.05). In the Sevoflurane group, an excessive effect occurred in 12% of responses, and in 26.7% in the Remifentanil group (P < 0.05). An inhalation bolus of sevoflurane seems to be more effective than an IV remifentanil bolus during maintenance, with more effective control of hemodynamic responses to surgical stress.

IMPLICATIONS: We compared an inhalation bolus of sevoflurane with remifentanil for managing hemodynamic responses to major abdominal or thoracic surgery. This prospective, randomized trial demonstrated better results with sevoflurane.




This article has been cited by other articles:


Home page
 Br J AnaesthHome page
B. Steinlechner, M. Dworschak, B. Birkenberg, T. Lang, A. Schiferer, A. Moritz, B. Mora, and A. Rajek
Low-dose remifentanil to suppress haemodynamic responses to noxious stimuli in cardiac surgery: a dose-finding study
Br. J. Anaesth., May 1, 2007; 98(5): 598 - 603.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Cucchiaro, S. D. Markowitz, R. Kaye, N. S. Adzick, R. S. Litman, C. A. Stanley, and M. F. Watcha
Blood Glucose Control During Selective Arterial Stimulation and Venous Sampling for Localization of Focal Hyperinsulinism Lesions in Anesthetized Children
Anesth. Analg., October 1, 2004; 99(4): 1044 - 1048.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
L. E. C. De Baerdemaeker, M. M. R. F. Struys, S. Jacobs, N. M. M. Den Blauwen, G. R. P. J. Bossuyt, P. Pattyn, and E. P. Mortier
Optimization of desflurane administration in morbidly obese patients: a comparison with sevoflurane using an 'inhalation bolus' technique
Br. J. Anaesth., November 1, 2003; 91(5): 638 - 650.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.