Paper Information

Journal:   ANESTHESIOLOGY AND PAIN MEDICINE   OCTOBER 2014 , Volume 4 , Number 4; Page(s) 0 To 0.
 
Paper: 

COMPARISON OF TWO CLINICAL PROTOCOLS FOR TOTAL INTRAVENOUS ANESTHESIA (TIVA) FOR BREAST SURGERY USING PROPOFOL COMBINED WITH EITHER SUFENTANIL OR ALFENTANIL

 
 
Author(s):  RADKE OLIVER C.*, SIPPEL DARJA, RADKE KATJA, HILGERS REINHARD, SAUR PETRA
 
* DEPARTMENT OF ANESTHESIA AND PERIOPERATIVE CARE, SAN FRANCISCO GENERAL HOSPITAL, UNIVERSITY OF CALIFORNIA IN SAN FRANCISCO, SAN FRANCISCO, USA
 
Abstract: 

Background: Sufentanil and alfentanil have pharmacokinetic and dynamic properties which make them favourable substances for total intravenous anesthesia (TIVA) in combination with propofol.
Objectives: We planned to compare two clinical protocols for TIVA with propofol, and either sufentanil or alfentanil in regards to postoperative pain, hemodynamic stability during the case and time for emergence from anesthesia.
Patinets and Methods: Treaty eight patients scheduled for general anesthesia for breast surgery were included in this Double-blind, randomized, controlled trial. All patients received a standardized TIVA with propofol and either 0.2
mg kg-1 sufentanil or 20 mg kg-1 alfentanil for induction and 0.3 mg kg-1 h-1 sufentanil or 30 mg kg-1 h-1 alfentanil for maintenance with additional propofol boluses as needed. During anesthesia, heart rate, non-invasive blood-pressure, peripheral oxygen saturation and depth of anesthesia, were recorded. In the post anesthesia care unit, pain scores, nausea and vomiting as well as medications were recorded.
Results: Patients in the sufentanil group required less often additional opioid and propofol boluses to maintain adequate anesthesia. We did not observe a significant difference in time to extubation. Postoperatively, patients in the sufentanil group had less pain (P=0.03) and required less i.v. opioids (0.4 vs.1.9 mg piritramid, P=0.04).
Conclusions: Both protocols provide excellent anesthesia, but patients receiving sufentnail had more stable anesthesia and less postoperative pain.

 
Keyword(s): INTRAVENOUS ANESTHESIA, PHARMACOKINETICS, POSTOPERATIVE PAIN, SUFENTANIL, ALFENTANIL
 
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