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Titolo:
DESFLURANE CONTROLS THE HEMODYNAMIC-RESPONSE TO SURGICAL STIMULATION MORE RAPIDLY THAN ISOFLURANE
Autore:
BENNETT JA; MAHADEVIAH A; STEWART J; LINGARAJU N; KEYKHAH MM;
Indirizzi:
HAHNEMANN UNIV,DEPT ANESTHESIOL,MAIL STOP 310,BROAD & VINE ST PHILADELPHIA PA 19102
Titolo Testata:
Journal of clinical anesthesia
fascicolo: 4, volume: 7, anno: 1995,
pagine: 288 - 291
SICI:
0952-8180(1995)7:4<288:DCTHTS>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Keywords:
DESFLURANE; HEMODYNAMICS; ISOFLURANE; SURGICAL STIMULATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
J.A. Bennett et al., "DESFLURANE CONTROLS THE HEMODYNAMIC-RESPONSE TO SURGICAL STIMULATION MORE RAPIDLY THAN ISOFLURANE", Journal of clinical anesthesia, 7(4), 1995, pp. 288-291

Abstract

Study Objective: To compare the control of hemodynamic response to surgical stimulus of desflurane to that of isoflurane. Design: Prospective randomized study. Setting: Operating room of a major U.S. teaching hospital. Patients: 59 ASA status I, II, and III patients 18 to 80 years of age and were undergoing orthopedic or intra-abdominal surgical procedures of I or more hours in duration. Interventions: Group 1 (n = 29) received desflurane in oxygen (O-2) for their surgical procedure. Group 2 (n = 30) received isoflurane in O-2 for their surgical procedure. Thiopental sodium 4 mg/kg and fentanyl 3 mu g/kg provided induction; vecuronium 0.1 mg/kg facilitated intubation. Prior to incision the volatile anesthetic drug was titrated to maintain systolic blood pressure (Ssp) within 20% of preinduction (baseline) values. Any time afterincision, an SEP increase greater than 20% of baseline was treated with a 30% increase in inspired anesthetic concentration for 3 minutes, or until SEP was within 10% of baseline. Another three 30% increases were allowed at 3 minute intervals to return SEP to 10% of baseline. Iffour 30% increases did not return SEP to 10% of baseline, additional fentanyl up to 5 mu g/kg or labetalol in 5 mg increments was given. Measurements and Main Results: Measurement of hemodynamics and anesthetic concentration occurred every 2 minutes prior to shin incision and every 5 minutes thereafter. Measurement of hemodynamics and anesthetic concentration occurred every minute during treatment of blood pressure (BP) response to surgical stimulus. Desflurane allowed for more rapid control of BP response to surgical stimulus median 2 minutes (range 1 to 12 minutes) for desflurane versus 6 minutes (range 1 to 12 minutes,p = 0.011). The desflurane group required fewer 30% incremental anesthetic increases than the isoflurane group (1.8 versus 2.5, p = 0.016) to control increased SEP. End tidal/inspired drug concentration ratioswere closer to unity in the desflurane patients both before (0.94 versus 0.80) and after (0.86 versus 0.70) changes in drug concentration to treat increased SEP. Conclusion: Anesthetic depth can be more rapidly titrated with desflurane compared to isoflurane. Alveolar/inspired concentration ratio approaches unity more rapidly with desflurane anesthesia.

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Documento generato il 07/04/20 alle ore 22:08:38