RESUMEN
BACKGROUND: Coughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation. METHODS: In total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 microg/kg/hr (Group S1) or 0.3 microg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery. RESULTS: Groups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences. CONCLUSIONS: A sufentanil infusion (0.2-0.3 microg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.
Asunto(s)
Humanos , Extubación Traqueal , Analgesia Controlada por el Paciente , Anestesia , Periodo de Recuperación de la Anestesia , Índice de Masa Corporal , Tos , Ojo , Hemodinámica , Hipertensión , Histerectomía , Incidencia , Isoflurano , Laringismo , Náusea , Anafilaxis Cutánea Pasiva , Náusea y Vómito Posoperatorios , Piel , Sufentanilo , Taquicardia , VómitosRESUMEN
BACKGROUND: Coughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation. METHODS: In total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 microg/kg/hr (Group S1) or 0.3 microg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery. RESULTS: Groups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences. CONCLUSIONS: A sufentanil infusion (0.2-0.3 microg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.
Asunto(s)
Humanos , Extubación Traqueal , Analgesia Controlada por el Paciente , Anestesia , Periodo de Recuperación de la Anestesia , Índice de Masa Corporal , Tos , Ojo , Hemodinámica , Hipertensión , Histerectomía , Incidencia , Isoflurano , Laringismo , Náusea , Anafilaxis Cutánea Pasiva , Náusea y Vómito Posoperatorios , Piel , Sufentanilo , Taquicardia , VómitosRESUMEN
Patients with cervical spine instability and limited range of motion are challenge to anesthesiologists. It is important to consider alternatetive methods for securing the airway while maintaining neutral position and minimizing neck motion, because these patients are at increased risk for tracheal intubation failure and neurologic injury during airway management or position change. We experienced two cases that patients had cervical spine instability and severe limited range of motion due to the fusion of the entire cervical spine. One patient was a 6-year-old girl weighing 12.7 kg and had Klippel-Feil syndrome with Arnold-Chiari malformation, the other was a 24-year-old female weighing 31 kg and had juvenile rheumatoid arthritis. We successfully performed the intubation by using the fiberoptic intubation though a laryngeal mask airway in these two cases.
Asunto(s)
Niño , Femenino , Humanos , Adulto Joven , Manejo de la Vía Aérea , Malformación de Arnold-Chiari , Artritis Juvenil , Intubación , Síndrome de Klippel-Feil , Máscaras Laríngeas , Cuello , Rango del Movimiento Articular , Columna VertebralRESUMEN
No abstract available.