Improved haemodynamic stability and cerebral tissue oxygenation after induction of anaesthesia with sufentanil compared to remifentanil: a randomised controlled trial.
Atropine
Haemodynamics
Induction of anaesthesia
Remifentanil
Sufentanil
Tissue oxygenation
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
07 10 2020
07 10 2020
Historique:
received:
15
05
2020
accepted:
24
09
2020
entrez:
8
10
2020
pubmed:
9
10
2020
medline:
14
9
2021
Statut:
epublish
Résumé
Balanced anaesthesia with propofol and remifentanil, compared to sufentanil, often decreases mean arterial pressure (MAP), heart rate (HR) and cardiac index (CI), raising concerns on tissue-oxygenation. This distinct haemodynamic suppression might be attenuated by atropine. This double blinded RCT, investigates if induction with propofol-sufentanil results in higher CI and tissue-oxygenation than with propofol-remifentanil and if atropine has more pronounced beneficial effects on CI and tissue-oxygenation in a remifentanil-based anaesthesia. In seventy patients scheduled for coronary bypass grafting (CABG), anaesthesia was induced and maintained with propofol target controlled infusion (TCI) with a target effect-site concentration (Cet) of 2.0 μg ml The sufentanil group compared to the remifentanil group showed significantly less decrease in MAP (∆ = - 23 ± 13 vs. -36 ± 13 mmHg), HR (∆ = - 5 ± 7 vs. -10 ± 10 bpm), SV (∆ = - 23 ± 18 vs. -35 ± 19 ml) and CI (∆ = - 0.8 (- 1.5 to - 0.5) vs. -1.5 (- 2.0 to - 1.1) l min Induction of anaesthesia with propofol and sufentanil results in improved haemodynamic stability and higher SctO Clinicaltrials.gov on June 7, 2013 (trial ID: NCT01871935 ).
Sections du résumé
BACKGROUND
Balanced anaesthesia with propofol and remifentanil, compared to sufentanil, often decreases mean arterial pressure (MAP), heart rate (HR) and cardiac index (CI), raising concerns on tissue-oxygenation. This distinct haemodynamic suppression might be attenuated by atropine. This double blinded RCT, investigates if induction with propofol-sufentanil results in higher CI and tissue-oxygenation than with propofol-remifentanil and if atropine has more pronounced beneficial effects on CI and tissue-oxygenation in a remifentanil-based anaesthesia.
METHODS
In seventy patients scheduled for coronary bypass grafting (CABG), anaesthesia was induced and maintained with propofol target controlled infusion (TCI) with a target effect-site concentration (Cet) of 2.0 μg ml
RESULTS
The sufentanil group compared to the remifentanil group showed significantly less decrease in MAP (∆ = - 23 ± 13 vs. -36 ± 13 mmHg), HR (∆ = - 5 ± 7 vs. -10 ± 10 bpm), SV (∆ = - 23 ± 18 vs. -35 ± 19 ml) and CI (∆ = - 0.8 (- 1.5 to - 0.5) vs. -1.5 (- 2.0 to - 1.1) l min
CONCLUSION
Induction of anaesthesia with propofol and sufentanil results in improved haemodynamic stability and higher SctO
TRIAL REGISTRATION
Clinicaltrials.gov on June 7, 2013 (trial ID: NCT01871935 ).
Identifiants
pubmed: 33028197
doi: 10.1186/s12871-020-01174-9
pii: 10.1186/s12871-020-01174-9
pmc: PMC7541228
doi:
Substances chimiques
Atropine
7C0697DR9I
Sufentanil
AFE2YW0IIZ
Remifentanil
P10582JYYK
Oxygen
S88TT14065
Banques de données
ClinicalTrials.gov
['NCT01871935']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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