Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test |
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Authors: | Imani F Jafarian A Hassani V Khan Z H |
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Affiliation: | 1 Department of Anaesthesiology, Rasool-Akram Hospital, School of Medicine, Iran University of Medical Sciences Tehran, Iran 2 Department of Anaesthesiology, Shafa-Yahyaeian Hospital, School of Medicine, Iran University of Medical Sciences Tehran, Iran 3 Department of Anaesthesiology, Imam Khomeini Medical Center, School of Medicine, Tehran University of Medical Sciences Tehran, Iran |
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Abstract: | Background. Wake-up test can be used during posterior spinalfusion (PSF) to ensure that spinal function remains intact.This study aims at assessing the characteristics of the wake-uptest during propofolalfentanil (PA) vs propofolremifentanil(PR) infusions for PSF surgery. Methods. Sixty patients with scoliosis and candidates for PSFsurgery were randomly allocated in either alfentanil (PA) orremifentanil (PR) group. After an i.v. bolus of alfentanil 30µg kg1 in the PA group or remifentanil 1 µgkg1 in the PR group, anaesthesia was induced with thiopentaland atracurium. During maintenance, opioid infusion consistedof alfentanil 1 µg kg1 min1 or remifentanil0.2 µg kg1 min1, in the PA group and thePR group, respectively. All patients received propofol 50 µgkg1 min1. Atracurium was given to maintain therequired surgical relaxation. At the surgeon's request, allinfusions were discontinued. Patients were asked to move theirhands and feet. Time from anaesthetic discontinuation to spontaneousventilation (T1), and from then until movement of the handsand feet (T2), and its quality were recorded. Results. The average T1 and T2 were significantly shorter inthe PR group [3.6 (2.5) and 4.1 (2) min] than the PA group [6.1(4) and 7.5 (4.5) min]. Quality of wake-up test, however, didnot show significant difference between the two groups studied. Conclusion. Wake-up test can be conducted faster with remifentanilcompared with alfentanil infusion during PSF surgery. |
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Keywords: | anaesthetics i.v., propofol analgesics opioid, alfentanil analgesics opioid, remifentanil measurement techniques, wake-up test |
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