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2007, Number 2

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Rev Mex Anest 2007; 30 (2)

Comparison of the effectiveness of two schemes of remifentanyl for haemodynamic control in patients undergoing major abdominal surgery

Reyes-Partida JA, Márquez-Gde VJ, Giles-Mojica M, Maldonado-Paredes O, Linares-Segovia B

Language: Spanish
References: 29
Page: 72-81
PDF size: 91.57 Kb.


ABSTRACT

Objective: To compare the effectiveness of two anesthesia schemes with remifentanyl for haemodynamic control in patients undergoing major abdominal surgery. Methods: An unblinded clinical trial was conducted in seventy-six patients aged 15-65 years, who were classified according to the American Society of Anesthesiologist physical status (ASA) I/II. The participants were selected by using a non-probabilistic consecutive sampling method from patients undergoing elective major abdominal surgery at the General Hospital of Salamanca, México. They were allocated randomly to receive total intravenous anesthesia (TIVA) with propofol/remifentanyl (n = 38, group I) or balanced general anesthesia with desflurane/remifentanyl (n = 38, group II). The systolic, diastolic and mean arterial pressure, heart rate and SpO2 were evaluated through the anesthesia periods, including emergency and recovery. Statistical analysis comprised non-paired t test and repeated-measures ANOVA with Bonferroni correction for multiple comparisons. Results: Group I had the higher median blood pressure during the period of major surgical stimulus (t = 3.441, p = 0.001). The scheme propofol/remifentanyl obtained better haemodynamic control and facilitated to maintain anesthetic depth control. The periods for eye opening (z = 0.136, p = 0.17) and recovery (z = 0.50, p = 0.61) were similar. Remifentanyl infusion rate (t = 0.844, p = 0.401) and plasma concentration (t = 1.101, p = 0.274) in both groups were similar. Conclusions: Intraoperative haemodynamic status of the patients undergoing major abdominal surgery was similar when using both anesthetic schemes, including fast and predictable recovery.


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