Abstract | OBJECTIVE: PATIENTS AND METHODS: Prospective, non randomized study. Forty female physical status ASA I-II patients between 18 and 60 years of age scheduled to undergo subcostal cholecystectomy by subcostal laparotomy (group CSL, n = 20) or by laparoscopy (group CL, n = 20). Total intravenous anesthesia with propofol, alfentanil and atracurium was provided. A continuous infusion of alfentamil 1 microgram/kg/min was used, with a supplement of 7 micrograms/kg when mean arterial pressure (MAP) rose more than 10% above baseline or with a supplement of 14 micrograms/kg when MAP rose 20% or more above baseline. Variables measured were intraoperative alfentanil requirements, time until extubation, presence and intensity of pain in the immediate postoperative period and incidence of vomiting. RESULTS:
Alfentanil consumption was 1.81 and 1.63 micrograms/kg/min and time to extubation was 17.5 and 14.05 min in the CL and CSL groups (p < 0.05), respectively. There was less pain in the early postoperative period in the CL group (36.8% for the CL patients as opposed to 85% in the CSL group, p < 0.01) and pain was less intense (p < 0.01). The incidence of vomiting was 42.1% in group CL and 25% in group CSL (p = NS). CONCLUSIONS: Insufflating the pneumoperitoneum for laparoscopic surgery brings about hemodynamic changes that increase intraoperative consumption of alfentanil during surgery, and this can lead to delayed awakening.
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Authors | E Figueredo-Gaspari, L Canosa-Ruiz |
Journal | Revista espanola de anestesiologia y reanimacion
(Rev Esp Anestesiol Reanim)
Vol. 44
Issue 3
Pg. 103-7
(Mar 1997)
ISSN: 0034-9356 [Print] Spain |
Vernacular Title | Necesidades de alfentanilo durante la anestesia total intravenosa. Comparación entre la colecistectomía laparoscópica y por laparotomía subcostal. |
PMID | 9229728
(Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article)
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Chemical References |
- Anesthetics, Intravenous
- Alfentanil
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Topics |
- Adolescent
- Adult
- Alfentanil
- Anesthesia, General
- Anesthesia, Intravenous
- Anesthetics, Intravenous
- Cholecystectomy, Laparoscopic
- Female
- Humans
- Laparotomy
(methods)
- Middle Aged
- Prospective Studies
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