Comparison of the effects of 2 different doses of remifentanil infusion for sedation during in-vitro fertilization procedure

To compare the sedation level, hemodynamic effects, patient and physician satisfactions following sedation achieved by 2 different doses of remifentanil [R] infusion with additional bolus infusions of propofol for in vitro fertilization [IVF] procedure. A double-blind prospective randomized study was implemented on 86 ASA I-II grade female patients, 18-40 years of age that underwent IVF procedure. This study was performed in the Department of Anesthesiology and Obstetrics and Gynecology, School of Medicine, Dokuz Eylul University, Izmir, Turkey between November 2006 to August 2008. Group R1 received 0.1mcg/kg/min while Group R2 received 0.15 mcg/kg/min infusion dose remifentanil. Side effects, total doses of remifentanil and propofol administered, heart rate [HR], systolic arterial pressure and diastolic arterial pressure values have been recorded. Fertilization, cleavage, and pregnancy rates together with prognosis of pregnancies were compared. Groups did not show statistically significant differences for hemodynamic parameters of HR and MAP [p=0.281]. Comparison of the satisfaction levels of 2 groups showed that anesthesiologist satisfaction was superior in R1 [p=0.009] whereas surgeon satisfaction was superior in R2 [p=0.01]. Both groups reported good patient satisfaction levels [p=0.31]. There were no differences between the groups in terms of fertilization, cleavage, pregnancy rates and prognosis of pregnancies [p>0.05]. Both doses of remifentanil provided stable hemodynamics along with fast and uncomplicated recovery

Use of laryngeal mask airway in anesthesia for treatment of retinopathy of prematurity

To review clinical experience of anesthesia management using laryngeal mask airway [LMA] during retinopathy of prematurity [ROP] photocoagulation. After obtaining the ethical approval from the Ethics Committee, we retrospectively reviewed the anesthesia records of 85 infants who underwent laser photocoagulation for ROP between June 2004 and June 2010 at the Department of Anesthesiology and Intensive Care, School of Medicine, Dokuz Eylul University, Izmir, Turkey. Anesthesia records were reviewed for airway management and respiratory complications in addition to medical and demographic data. The mean gestational age was 28.61 +/- 2.62 weeks, birth weight was 1205.24 +/- 384.51 g, post-conceptional age was 38.21 +/- 7.01 weeks, and weight at the time of operation was 2323.9 +/- 588.6 g. Laryngeal mask airway was used with minimal complications in all patients, even in patients with chronic lung disease including bronchopulmonary dysplasia. After the ROP treatment, the LMA was successfully removed in all infants under deep anesthesia and none of the patients needed endotracheal intubation or ventilatory support. Laryngeal mask airway is a safe and easy to use alternative for airway management during laser photocoagulation procedure in infants with ROP

Comparison of the effectiveness of pretreatment by fentanyl and remifentanil on rocuronium induced injection pain

To compare the efficacy of fentanyl and remifentanil as prodrugs in the prevention of rocuronium injection pain by using a control group. In a randomized, double-blinded, controlled study, 102 adult patients aged between 18-60 undergoing elective surgery under general anesthesia and classified into American Society of Anesthesiologists ASA I and ASA II risk groups were included in the study. The study was carried out from July 2005 to April 2006 at Dokuz Eylul University, Izmir, Turkey. Unpremedicated patients were randomly allocated to one of 3 groups. Patients received 2 mL 0.02 mg of remifentanil n =34, 2 mL of fentanyl 0.1 mg n=34, and 2 mL of saline n =34, by injection over 10 seconds. Thirty seconds after prodrug administration, 10 mg 10 mg/mL intravenous rocuronium bromide was administered over 5 seconds and pain assessment was performed by using a 5-point scale. When the 3 groups of 34 patients were compared in terms of pain assessment scoring, a statistically significant difference was determined p=0.02. When the groups were paired, it was seen that this difference resulted from the remifentanil and saline groups p=0.02. This study shows that a bolus dose of 0.02 mg of remifentanil is a more effective prodrug administration compared to the application of saline, however, remifentanil and fentanyl have no superiority over one another and the administration of fentanyl is equally effective as saline prodrug administration