INTRODUCTION: Emergence from general anesthesia and especially post-extubation phase are the stages associated with cardiovascular hyperdynamic status in which patients with increased intracranial pressure (ICP) could be affected by severe cardiac and or cerebral complications. Administering remifentanil could be helpful in maintaining the hemodynamic stability at the end of the surgery and recovery stages and reducing recovery phase length. METHODS: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving remifentanil and placebo as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation. RESULTS: There was a significant difference between two groups regarding the changes of Mean Arterial Pressure after extubation and five minutes after extubation (P˂ 0.001).Remifentanil group compared with control group was of significant difference at all heart rate values after extubation (P< 0.001). CONCLUSION:Remifentanil could be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length. However, administration of this medication should be performed cautiously.
RCT Entities:
INTRODUCTION: Emergence from general anesthesia and especially post-extubation phase are the stages associated with cardiovascular hyperdynamic status in which patients with increased intracranial pressure (ICP) could be affected by severe cardiac and or cerebral complications. Administering remifentanil could be helpful in maintaining the hemodynamic stability at the end of the surgery and recovery stages and reducing recovery phase length. METHODS: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving remifentanil and placebo as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation. RESULTS: There was a significant difference between two groups regarding the changes of Mean Arterial Pressure after extubation and five minutes after extubation (P˂ 0.001).Remifentanil group compared with control group was of significant difference at all heart rate values after extubation (P< 0.001). CONCLUSION:Remifentanil could be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length. However, administration of this medication should be performed cautiously.
Authors: J Schüttler; S Albrecht; H Breivik; S Osnes; C Prys-Roberts; K Holder; M Chauvin; J Viby-Mogensen; T Mogensen; I Gustafson; L Lof; D Noronha; A J Kirkham Journal: Anaesthesia Date: 1997-04 Impact factor: 6.955
Authors: J Guy; B J Hindman; K Z Baker; C O Borel; M Maktabi; N Ostapkovich; J Kirchner; M M Todd; P Fogarty-Mack; V Yancy; M D Sokoll; A McAllister; C Roland; W L Young; D S Warner Journal: Anesthesiology Date: 1997-03 Impact factor: 7.892
Authors: Federico Bilotta; Arthur M Lam; Andrea Doronzio; Vincenzo Cuzzone; Roberto Delfini; Giovanni Rosa Journal: J Clin Anesth Date: 2008-09 Impact factor: 9.452