Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2021.62.233
Remifentanil target-controlled infusion with intranasal dexmedetomidine for vitreoretinal procedures: a randomized controlled trial
Iztok Potočnik
; Department of Anesthesiology and Intensive Care, Institute of Oncology Ljubljana, Ljubljana, Slovenia
Lea Andjelkovič-Juvan
; Clinical Department of Anesthesiology and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia
Andrej Hostnik
; Clinical Department of Anesthesiology and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia
Jasmina Markovič-Božič
; Clinical Department of Anesthesiology and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia
Sažetak
Aim To evaluate the consumption of remifentanil (as a primary end-point), analgesia, sedation, hemodynamics, respiratory effects, and surgeon and patient satisfaction (as
a secondary end-point) with dexmedetomidine sedation
compared with those of remifentanil sedation in patients
undergoing vitreoretinal surgery.
Methods Patients subjected to retinal ophthalmic surgical procedures were randomized to one of two intraoperative sedation groups: one group (n=21) received intranasal dexmedetomidine plus intravenous remifentanil
(DEX-REMI group), and the other group (n=19) received
intravenous remifentanil only (REM group). The treatment
was placebo-controlled. The sedation level was controlled
according to the bispectral index, with target values between 80%-90%. Patient levels of comfort, sedation, and
pain were documented. The number of intraoperative
complications and the level of satisfaction were assessed.
Remifentanil consumption and hemodynamic parameters
were also included in the statistical analysis.
Results The level of remifentanil consumption was significantly lower in the DEX-REMI group, but combination sedation improved the surgeon’s, anesthesiologist’s,
and patients’ satisfaction scores. Importantly, the number
of complications was zero in the DEX-REMI group, while
eight cases of complications were noted in the REM group.
The DEX-REMI group showed lower mean minimal arterial
pressure, but it was still in the normotensive range.
Conclusions For patients undergoing ophthalmic procedures, sedation with a combination of intranasal dexmedetomidine and an intravenous infusion of remifentanil
provides lower remifentanil consumption, better satisfaction scores, and a lower complication rate than sedation
with a remifentanil infusion alone.
Ključne riječi
Hrčak ID:
278132
URI
Datum izdavanja:
24.6.2021.
Posjeta: 710 *