ABSTRACT
OBJECTIVE: 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. METHODS: 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 0.1 mcg/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. RESULTS: 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). CONCLUSION: Both doses of remifentanil provided stable hemodynamics along with fast and uncomplicated recovery.
Subject(s)
Fertilization in Vitro , Hypnotics and Sedatives/administration & dosage , Piperidines/administration & dosage , Adolescent , Adult , Deep Sedation , Double-Blind Method , Female , Humans , Prospective Studies , Remifentanil , Young AdultABSTRACT
Endoscopic sphincterotomy is commonly used for retained bile stones. We report a 24-year-old woman who showed bilateral tension pneumothorax and duodenal perforation following endoscopic sphincterotomy performed under sedation. These complications are rare in the literature have significant mortality and morbidity.
Subject(s)
Duodenum/injuries , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Pneumothorax/etiology , Pneumothorax/surgery , Postoperative Complications/therapy , Sphincterotomy, Endoscopic/adverse effects , Anesthesia, General , Conscious Sedation , Female , Humans , Laparotomy , Lung/diagnostic imaging , Pneumothorax/diagnostic imaging , Radiography , Young AdultABSTRACT
Serotonin syndrome occurs with selective serotonin reuptake inhibitors, opioids, and other serotonergic agents. We describe a possible serotonin syndrome related to intrathecal fentanyl in a patient taking multiple drugs and substances such as ergot alkaloids, marijuana, methylenedioxy-N-methylamphetamine, and ephedrine.
