Analgesia-based Sedation Using Remifentanil during Percutaneous Endoscopic Lumbar Discectomy.
10.4097/kjae.2006.50.1.36
- Author:
Kyungil HWANG
1
;
Hoyeon LEE
;
Kyudae SHIM
;
Dongyun KIM
;
Chanshik SHIM
;
Sangho LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Wooridul Spine Hospital, Seoul, Korea. usu97@naver.com
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
analgesia-based sedation;
percutaneous endoscopic lumbar discectomy;
remifentanil
- MeSH:
Analgesia;
Blood Pressure;
Diskectomy*;
Fentanyl;
Heart Rate;
Humans;
Incidence;
Respiratory Rate;
Spine
- From:Korean Journal of Anesthesiology
2006;50(1):36-41
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study was to examine the safety and efficacy of sedation and analgesia using remifentanil during percutaneous endoscopic lumbar discectomy (PELD). METHODS: Eighty ASA patients with physical status 1 or 2 who underwent a PELD were enrolled in this study. They were randomized to receive one of two treatments: a fentanyl bolus of 0.7microgram/kg 5 min before the procedure and of 0.7microgram/kg during the procedure (n = 40, group F), or a remifentanil titration at an infusion rate of 0.1-0.3microgram/kg/min available throughout the procedure according to the appeal of pain, level of sedation and side-effects (n = 40, group R). The observer's assessment of alertness/sedation (OAA/S) scale, blood pressure, heart rate, respiratory rate, SpO2, and end tidal CO2 were assessed and measured during and/or after the procedures. The visual analogue scale of pain (VAS), and the patient and endoscopist satisfaction scale were assessed after the procedures. RESULTS: There were no significant differences between the two groups in terms of the recovery characteristics, incidence of complications and satisfaction score of patients. In 92.5% of the cases among the remifentanil group, the spine surgeon made uniform judgements that remifentanil worked better than the usually used fentanyl procedure, whereas in 7.5% of the cases the effects were indifferent. The VAS score of the R group was significantly lower than that of the F group. CONCLUSIONS: We concluded that sedation and analgesia with remifentanil is very useful for painful local procedures such as PELDs.
