Original scientific paper
https://doi.org/10.22514/SV141.052018.3
Haemodynamic stability during anaesthesia induction with propofol – impact of phenylephrine. A double-blind, randomised clinical trial.
MIRT KAMENIK
; Department of Anaesthesiology, Intensive Care and Pain Management University Medical Centre Maribor Ljubljanska ulica 5, SI-2000 Maribor, SLOVENIA
DARJAN KOS
Andreja MÖLLER PETRUN
DAVID W GREEN
NUŠKA ZORKO
DUŠAN MEKIŠ
Abstract
Background. We studied the efects of a
parallel phenylephrine infusion during
bispectral index guided anaesthesia induction
with propofol on haemodynamic
parameters. We hypothesised that mean arterial
pressure and cardiac index would be
better maintained in the group of patients
receiving the phenylephrine infusion during
induction.
Methods. We studied ASA I-III patients
scheduled for oncological abdominal surgery.
Forty patients randomly received either
a 0.9% NaCl or a phenylephrine (0.5
μg/kg/min) infusion during the induction
of anaesthesia with propofol to a bispectral
index value of 60. Mean arterial pressure,
stroke volume index and systemic vascular
resistance index were recorded, starting at
one minute before induction for 20 minutes,
at one-minute intervals.
Results. Afer induction of anaesthesia
before intubation mean arterial pressure
and stroke volume index decreased signifcantly
compared to baseline in both
groups, while the systemic vascular resistance
index increased slightly. At the end
of measurements, mean arterial pressure
(66 ± 11 vs. 94 ± 14 mmHg; 0.9% NaCl vs.
phenylephrine group p<0.01) and stroke
volume index (34.2 ± 9.1 vs. 44.0 ± 9.7 ml/
m2; 0.9% NaCl vs. phenylephrine group
p<0.01) were lower in both groups in comparison
to baseline values, but were better
maintained in the phenylephrine group,
whereas systemic vascular resistance index
was higher than at baseline (2308 ± 656 vs.
3198 ± 825 dynes s/cm5/m2; 0.9% NaCl vs.
phenylephrine group p<0.01) with signifcant
diferences between groups.
Conclusion. Our study shows that a continuous
phenylephrine infusion can attenuate
the drop in mean arterial pressure and
stroke volume index during anaesthesia
induction with propofol.
Keywords
anaesthetics; propofol; monitoring; depth of anaesthesia; consciousness monitors; bispectral index; sympathetic nervous system; phenylephrine; measurement techniques; cardiac output
Hrčak ID:
200417
URI
Publication date:
1.6.2018.
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