1.The Efficacy of Epinephrine-Containing Test Dose during Propofol-Nitrous Oxide Anesthesia with High Dose Fentanyl.
Nam Hoon KOO ; Yunseok JEON ; Yong Chul KIM ; Young Jin LIM ; Sanglee PARK ; Byung Moon HAM
Korean Journal of Anesthesiology 2006;51(4):411-414
BACKGROUND: The aim of this study is to determine the effect of high dose fentanyl on the test dose containing 15microgram epinephrine during propofol anesthesia. METHODS: One hundred patients with ASA physical status 1 were randomized to receive 2 mg/kg propofol with or without 10microgram/kg fentanyl at the induction of anesthesia (n = 50 each). Anesthesia was maintained with propofol 8 mg/kg/h and 67% nitrous oxide in oxygen. Each group of patients were further divided into a test dose group receiving 1.5% lidocaine 3 ml plus epinephrine 15microgram or a saline group receiving 3 ml of isotonic saline (n = 25 each). Heart rate (HR) and systolic blood pressure (SBP) were monitored for 4 min after intravenous injection of the study drugs. RESULTS: In the propofol and the propofol-fentanyl group, the intravenous injection of the test dose produced a HR increase > or = 20 bpm (conventional HR criterion) in 25 and 23 out of the total 25 patients, respectively. Therefore, in the propofol-fentanyl group, sensitivity, specificity, positive predictive value, and negative predictive value were 82%, 100%, 100%, and 92.6%. According to the modified HR criterion (HR increase > or = 10 bpm), all the values were 100%. All patients receiving test dose developed SBP increase > or = 15 mmHg. CONCLUSIONS: Our results indicate that both HR increase > or = 10 bpm or SBP increase > or = 15 mmHg are clinically applicable during propofol-nitrous oxide anesthesia with 10microgram/kg fentanyl.
Anesthesia*
;
Blood Pressure
;
Epinephrine
;
Fentanyl*
;
Heart Rate
;
Humans
;
Injections, Intravenous
;
Lidocaine
;
Nitrous Oxide
;
Oxygen
;
Propofol
;
Sensitivity and Specificity