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Titolo:
Remifentanil in neuroanaesthesia - a multi-centre survey
Autore:
Thees, C; Frenkel, C; Hoeft, A;
Indirizzi:
Univ Bonn, Klin & Poliklin Anasthesiol & Spezielle Intensivm, D-53105 Bonn, Germany Univ Bonn Bonn Germany D-53105 pezielle Intensivm, D-53105 Bonn, Germany
Titolo Testata:
ANASTHESIOLOGIE & INTENSIVMEDIZIN
fascicolo: 4, volume: 42, anno: 2001,
pagine: 205 - 211
SICI:
0170-5334(200104)42:4<205:RIN-AM>2.0.ZU;2-R
Fonte:
ISI
Lingua:
GER
Soggetto:
CEREBRAL BLOOD-FLOW; INTRACRANIAL-PRESSURE; NITROUS-OXIDE; PHARMACOKINETICS; ALFENTANIL; CRANIOTOMY; PHARMACODYNAMICS; ANESTHESIA; SUFENTANIL; GI87084B;
Keywords:
narcotics; neurosurgery; anaesthesia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Thees, C Univ Bonn, Klin & Poliklin Anasthesiol & Spezielle Intensivm, Sigmund Freud Str 25, D-53105 Bonn, Germany Univ Bonn Sigmund Freud Str 25 Bonn Germany D-53105 onn, Germany
Citazione:
C. Thees et al., "Remifentanil in neuroanaesthesia - a multi-centre survey", ANASTH INTM, 42(4), 2001, pp. 205-211

Abstract

The aim of a modern fast-track approach for neuroanaesthesia is the early extubation and neurological examination following neurosurgical interventions. Haemodynamic stability, maintenance of the cerebral autoregulation and a fast recovery without respiratory depression should be guaranteed. This seems to be achieved by the new ultra-short acting opioid remifentanil. The intention of this study was to investigate the quality of remifentanil-supplemented anaesthesia in neurosurgery in a large number of patients under conditions of clinical routine. After approval by the ethical committee and informed consent of the neurosurgical patients (ASA I - IV) 938 anaesthesia with remifentanil as analgesic drug were evaluated. Apart from demographic data, remifentail dosage and haemodynamics at determined timepoints interventions for haemodynamic stabilisation and negative side effects of remifentanil were recorded as well asvigilance and onset spontaneous ventilation during the recovery phase. In 24.4% of the cases volatile anaesthetics were used, in 75.6% TIVA was performed using propofol. For induction of anaesthesia 0.49 +/- 0.35 mug(-1)kg(-1) min(-1) (mean, SD) remifentanil were administered. Intra operative analgesia was maintained applicating 0.23 +/- 0.14 mug(-1) kg(-1) min(-1). In 229 cases (24.4%) additional remifentanil boli had been administered, mostly because of changing operative conditions or increasing blood pressure. The duration of the remifentanil-infusion was 3.4 +/- 2.1 h, Spontaneous breathing started 7.5 +/- 5.3 min following the remifentanil-infusion. The patients could be contacted after 10 +/- 7.4 min and were oriented after 15.4 +/- 12.3 min. 81.9% of the patients could be extubated in the operating theatre. In 10 cases (= 1.1%) disadvantageous side effects of remifentanil had been documented (hypotension, brady-cardia, chest wall rigidity), None of these incidents had been classified "severe". Excellent control of analgesia, stable intraoperative haemodynamics as well as advantagous characteristics of postoperative recovery in our investigation demon-anaesthesia, especially when an early extubation is desired.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 12:44:45