Hemodynamic responses to 1 MAC desflurane inhalation during anesthesia induction with propofol bolus and remifentanil continuous infusion: a prospective randomized single-blind clinical investigation
- 주제(키워드) Desflurane , Sevoflurane , Remifentanil , Hemodynamic response , Age
- 주제(기타) Anesthesiology
- 설명문(일반) [Lee, Jong Wha] Ewha Womans Univ, Sch Med, Dept Anesthesiol & Pain Med, Seoul, South Korea; [Kim, Mi Kyeong] Kyung Hee Univ, Med Ctr, Dept Anesthesiol & Pain Med, Seoul, South Korea; [Kim, Ji Young] Yonsei Univ, Coll Med, Anesthesia & Pain Res Inst, Dept Anesthesiol & Pain Med, Seoul, South Korea; [Kim, Ji Young] Yonsei Univ Hlth Syst, Gangnam Severance Hosp, Dept Anesthesiol & Pain Med, 211 Eonju Ro, Seoul 06273, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 BMC
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000204236
- 본문언어 영어
- Published As https://doi.org/10.1186/s12871-023-02002-6
초록/요약
Background Desflurane is not recommended during anesthesia induction because of its sympathetic stimulation effect, particularly in patients with myocardial ischemic disease. To date, the hemodynamic response to 1 MAC desflurane inhalation in combination with remifentanil infusion during anesthesia induction has rarely been reported.Methods This investigation was designed to compare hemodynamic responses to 1 MAC desflurane (group D, n = 200) with sevoflurane (group S, n = 200) during anesthesia induction and endotracheal intubation in adult patients undergoing elective spine surgery. Subgroup analysis of the different age subgroups was also performed. With continuous infusion of remifentanil 0.1 mu g/kg/min, anesthesia was induced with propofol bolus, and endotracheal intubation was performed after muscle relaxation. Heart rate (HR) and mean arterial blood pressure (MAP) were measured every minute for 5 min after anesthesia induction (T1-5) and after endotracheal intubation (T6-10).Results HR was significantly higher in group D (n = 182) than in group S (n = 173) at T3-10 except at T6 (1 min after intubation) (all P < 0.05). In the age-based subgroup analyses, which subdivided the group D and S into four subgroups based on patient's age, the changes in HR from baseline values were significantly different between the coeval subgroups of patients in their 20-29 years and 30-39 years of age (all P < 0.05). MAP was reduced from baseline value, irrespective of group and age.Conclusion Inhalation of 1 MAC desflurane during anesthesia induction with propofol bolus and remifentanil continuous infusion and during endotracheal intubation was more likely to induce elevations in HR more likely than 1 MAC sevoflurane, especially in younger patients.
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