Effect-site concentrations of remifentanil causing bradycardia in hypnotic and non-hypnotic patients.
Although the induction of anaesthesia with remifentanil often causes bradycardia, the relationship between the effect-site concentration (Ce) of remifentanil and instantaneous heart rate (HR) has remained unclear. The present study examined the relationship between instantaneous HR and remifentanil...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 30; no. 6; pp. 919 - 925 |
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| Autores principales: | , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120548706&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120548706 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Dec2016 vid: 30 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 120548706 120548706 NLM26462495 120548706 10.1007/s10877-015-9794-4 NLM26462495 120548706 ppf: 919 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Effect-site concentrations of remifentanil causing bradycardia in hypnotic and non-hypnotic patients. aug: au: Hayashi, Kazuko Tanaka, Akiko affil: Department of Anesthesiology , Nantan General Hospital , Yagi Ueno 25 Nantan City 629-0141 Japan sug: subj: Heart Rate Hypnotics and Sedatives Administration and Dosage Bradycardia Chemically Induced Piperidines Pharmacodynamics Anesthetics, Intravenous Pharmacodynamics Aged, 80 and Over Female Electrocardiography Aged Anesthesia Time Factors Adult Male Blood Pressure Drug Effects Analgesics, Opioid Therapeutic Use Propofol Administration and Dosage Middle Age Human Aged, 80 & over Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Although the induction of anaesthesia with remifentanil often causes bradycardia, the relationship between the effect-site concentration (Ce) of remifentanil and instantaneous heart rate (HR) has remained unclear. The present study examined the relationship between instantaneous HR and remifentanil Ce at the induction of anaesthesia with and without propofol hypnosis, to facilitate safe management of anaesthesia induction with remifentanil. Instantaneous HR was calculated every 5 s using an electrocardiographic real-time analysis system (MemCalc/Makin2; GMS, Tokyo, Japan). At the beginning of anaesthesia induction, continuous infusion of remifentanil (1 μg min-1 kg-1) preceded hypnosis with propofol in 13 patients [non-hypnosis group; mean age, 67.8 (17.5) years], while propofol bolus (30-50 mg) was injected together with continuous remifentanil medication in 18 patients [hypnosis group; mean age, 62.9 (16.5) years]. Remifentanil Ce was estimated every 5 s using the three-compartment model proposed by Minto et al. and the relationship between estimated remifentanil Ce and instantaneous HR was examined. In the hypnosis group, HR was significantly lower than basal HR when remifentanil Ce was increased to 3.5 ng ml-1 (p < 0.05), whereas no significant HR reduction was found in the non-hypnosis group until remifentanil Ce reached >5 ng ml-1 (p < 0.05). The induction of anaesthesia using remifentanil with propofol hypnotics significantly reduces HR even in a low remifentanil Ce insufficient to suppress the cardiovascular response at tracheal intubation. Preparations to treat bradycardia are recommended for the safe management of anaesthesia induction when remifentanil is combined with hypnotics. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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