J-Y Hong1, Y S Kang, H K Kil. 1. Yonsei University College of Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Department of Anesthesiology and Pain Medicine, Seoul, South Korea. jenyhongg@hanmail.net
Abstract
BACKGROUND AND OBJECTIVE: A randomized and prospective study was performed to compare anaesthetic characteristics and stress hormone responses of two anaesthetic techniques. METHODS:Forty-two patients undergoing day case excisional biopsy of breast mass were randomly assigned to receive propofol-remifentanil or sevoflurane-N2O. Anaesthesia was induced and maintained either with sevoflurane and 50% N2O in oxygen or with target-controlled remifentanil and propofol in 50% oxygen and air. Anaesthetic depth was monitored by the bispectral index. RESULTS: The times for induction (2.9 vs. 1.7 min) and for laryngeal mask insertion (5.7 vs. 3.3 min) were longer in the sevoflurane-N2O group than in the propofol-remifentanil group. However, apnoea (57.1% vs. 9.5%) and bradycardia (23.8% vs. 0%) were more prevalent with propofol-remifentanil. In the sevoflurane-N2O group, the emergence times to a verbal response (10.6 vs. 3.7 min), to extubation (11.8 vs. 4.0 min) and to orientation (14.7 vs. 4.8 min) were longer than in the propofol-remifentanil group. There were significantly more nausea (38.1% vs. 4.8%) and vomiting (19.2% vs. 0%) in the sevoflurane-N2O group than in the propofol-remifentanil group. The time to discharge was similar although there was less postoperative pain in the sevoflurane-N2O group. There were no differences in the perioperative cortisol responses in the two groups. CONCLUSIONS: Smoother induction of anaesthesia was seen with sevoflurane-N2O. Propofol-remifentanil showed a quicker emergence with less nausea/vomiting. There were similar perioperative cortisol responses in the two anaesthetic techniques.
RCT Entities:
BACKGROUND AND OBJECTIVE: A randomized and prospective study was performed to compare anaesthetic characteristics and stress hormone responses of two anaesthetic techniques. METHODS: Forty-two patients undergoing day case excisional biopsy of breast mass were randomly assigned to receive propofol-remifentanil or sevoflurane-N2O. Anaesthesia was induced and maintained either with sevoflurane and 50% N2O in oxygen or with target-controlled remifentanil and propofol in 50% oxygen and air. Anaesthetic depth was monitored by the bispectral index. RESULTS: The times for induction (2.9 vs. 1.7 min) and for laryngeal mask insertion (5.7 vs. 3.3 min) were longer in the sevoflurane-N2O group than in the propofol-remifentanil group. However, apnoea (57.1% vs. 9.5%) and bradycardia (23.8% vs. 0%) were more prevalent with propofol-remifentanil. In the sevoflurane-N2O group, the emergence times to a verbal response (10.6 vs. 3.7 min), to extubation (11.8 vs. 4.0 min) and to orientation (14.7 vs. 4.8 min) were longer than in the propofol-remifentanil group. There were significantly more nausea (38.1% vs. 4.8%) and vomiting (19.2% vs. 0%) in the sevoflurane-N2O group than in the propofol-remifentanil group. The time to discharge was similar although there was less postoperative pain in the sevoflurane-N2O group. There were no differences in the perioperative cortisol responses in the two groups. CONCLUSIONS: Smoother induction of anaesthesia was seen with sevoflurane-N2O. Propofol-remifentanil showed a quicker emergence with less nausea/vomiting. There were similar perioperative cortisol responses in the two anaesthetic techniques.
Authors: Daniel K O'Neill; Bryan Robins; Elizabeth A Ayello; Germaine Cuff; Patrick Linton; Harold Brem Journal: Int Wound J Date: 2012-04-20 Impact factor: 3.315
Authors: Anthony G Messina; Michael Wang; Marshall J Ward; Chase C Wilker; Brett B Smith; Daniel P Vezina; Nathan Leon Pace Journal: Cochrane Database Syst Rev Date: 2016-10-18