Hemodynamic responses to 1 MAC desflurane inhalation during anesthesia induction with propofol bolus and remifentanil continuous infusion: a prospective randomized single-blind clinical investigation

BMC Anesthesiology

Research

Ji Young Kim¹  Jong Wha Lee²  Mi Kyeong Kim³ 

[1] Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University Health System, 211, Eonju-Ro, Gangnam-Gu, 06273, Seoul, Republic of Korea;Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea;Department of Anesthesiology and Pain Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea;

关键词: Desflurane;    Sevoflurane;    Remifentanil;    Hemodynamic response;    Age;   

DOI  :  10.1186/s12871-023-02002-6

 received in 2022-11-22, accepted in 2023-02-01,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDesflurane 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.MethodsThis 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 μg/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).ResultsHR 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.ConclusionInhalation 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.Trial registrationThis study was registered in the Clinical Research Information Service (CRIS, http://cris.nih.go.kr) of the Republic of Korea on Feb 12, 2016 (Registration No. KCT 0,001,813).

【 授权许可】

CC BY   
© The Author(s) 2023

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