Comparison between remifentanil and dexmedetomidine for controlled hypotension in endoscopie sinus surgery
10.3969/j.issn.1006-5725.2014.14.044
- VernacularTitle:瑞芬太尼与右美托咪定用于鼻内镜手术控制性降压的对比研究
- Author:
Kai XU
;
Minmin ZHU
;
Yiping HU
- Publication Type:Journal Article
- Keywords:
Remifentanil;
Dexmedetomidine;
Controlled;
Hypotension;
Endoscopic Sinus Surgery
- From:
The Journal of Practical Medicine
2014;(14):2305-2308
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical effect of remifentanil and dexmedetomidine on controlled hypotension during endoscopic sinus surgery. Methods Forty patients undergoing endoscopic sinus surgery were randomly divided into group R and group D, 20 in each group. All patients received controlled hypotension when the surgeons began to sterilize the nasal cavity for the purpose of maintaining the MAP at 60 ~ 70 mmHg. Group R received remifentanil 1μg/kg over 1 minute, followed by 0.2 to 0.4μg/kg per minute infusion during maintenance, whereas group D received dexmedetomidine 1μg/kg over 10 minutes, followed by 0.2 to 0.7μg/kg per hour during maintenance. At the moment of pre-induction(T0), incision(T1), 30 min(T2) and 60 min(T3) after incision and 10 min(T4) after end of controlled hypotension, MAP and HR were measured. Quality of the surgical field, blood loss and extubation time were recorded. Sedation and postoperative pain were assessed on arrival at the PACU. Results The goals for the MAP level were achieved and the surgical field quality was ideal in both groups. The MAP and HR values at T1~ T3 were significantly lower than those at T0 in both groups (P < 0.05). There were no significant differences in the MAP or HR values between the groups at each time point (P>0.05). No significant difference was founded between the groups in the Fromme operative field score and blood loss (P > 0.05). The extubation time was significantly shorter in group R than in group D(P<0.05). The sedation score in the PACU was significantly lower in group R than in group D(P<0.05), while there were no significant differences in postoperative pain between the groups(P<0.05). Conclusion Both remifentanil and dexmedetomidine are safe agents for controlled hypotension and are effective in providing satisfactory surgical fields during endoscopic sinus surgery. However , remifentanil is advantageous in time for extubation and complete consciousness from anesthesia and therefore it may have the advantage of fast track anesthesia.
