BibTex RIS Cite

REMİFENTANİL VE ALFENTANİLİN ENDOTRAKEAL ENTÜBASYONDA SPİROMETRİK PARAMETRELER ÜZERİNE OLAN ETKİLERİNİN DEĞERLENDİRİLMESİ

Year 2006, Volume: 7 Issue: 2, 37 - 41, 01.08.2006

Abstract

Amaç:Çalışmamızın amacı remifentanil ve alfentanil kullanılan hastalarda endotrakeal entübasyona yanıtolarak oluşan solunumsal değişikliklerin etkilerini spirometrik olarak araştırmaktır.Gereç ve yöntem:Çalışma retrospektif olarak hasta dosyalarındaki anestezi takip fişleri taranarak, genelanestezi altında opere olan 18-60 yaş arası 40 olgu seçilerek 2 eşit grup oluşturularak gerçekleştirildi.Remifentanil (Ultiva®,) grubunda (Grup R) remifentanil; entübasyondan önce 1 µg/kg İV bolus, entübasyondansonra 0.25 g/kg/dak. infüzyonla, alfentanil (Rapifen®) grubunda (Grup A) alfentanil; entübasyondan önce 20g/kg İV bolus ve entübasyondan sonra 1 g/kg/dak infüzyonla uygulanmış. İlaç verildikten sonra,µ entübasyondan hemen önce ve sonra, intraoperatif 5., 10. dakikalarda spirometreyle pik inspiratuvar basınç(PİP), plato basıncı (Pplato), havayolu direnci (Raw), akciğer kompliyans (C) değerleri kaydedilmiştir.Bulgular:Gruplar arasında pik inspiratuar basınç, plato basıncı, kompliyans değerleri arasında anlamlı farksaptanmazken; havayolu direnci bazal değerleri arasında alfentanil grubunda daha düşük olmak üzere istatikselolarak anlamlı fark saptandı (P

References

  • 1. Conti G, Cosmo DG, Bocci MG, Antonelli M, Ferro G, Costa R, Zito G, Proietti R.Alfentanil does not increase resistance of the respiratory system in ASA I patients ventilated mechanically during general anesthesia. Can JAnesth 2002; 49: 71823
  • 2. Billard V, Cazalaa JB, Servin F, Viviard X. Anesthesie intraveineuse a objektif de concentration. Ann Fr Anesth Reanim 1997; 16: 250-73
  • 3. Vuyk J, Lim T, Engbers FHM, Burm AGL, Vletter AA, Bovill JG. The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women.Anesthesiology 1995; 83: 8-22
  • 4. Smith C, McEwan AL, Jhaveri R, et al. The interaction of fentanyl on the Cp of propofol for of loss consciousness and skin incision. Anesthesiology 1994; 81:820-8
  • 5. James MK, Feldman PL, Schuster SV, Bilotta JM, Brackeen MF, Leighton HJ. Opioid receptor activity of GI 87084B, a novel ultra-short acting analgesic, in isolated tissues. J Pharmacol Exp Ther 1991; 259:712- 8.
  • 6. Barash PG, Cullen BF, Stoelting RK. Handbook of Clinical Anesthesia, ingilizce 3. baskıdan Türkçe'ye cevrilmiş, 3. baskı (Çeviren: Elar Z.) İstanbul: Logos yayıncılık, 1999; 122-3.
  • 7. Glass PSA, Gan TJ, Howel S. A review of the pharmacokinetics and pharmacodynamics of remifentanil.AnaesthAnalg 1999; 89: 7-14.
  • 8. Bailey PL, Egan TD, Stanley TH. Intravenous Opoid Anesthetica. 5th ed. New York: Churchill Livingstone, 2000:273-377.
  • 9. Albrecht S, Schuttler J, Yarmush J. Postoperative pain management after intraoperative remifentanil. Anesth Analg 1999; 89 :40-5.
  • 10. Hogue CW Jr, Bowdle TA, O'Leary C. A multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery. AnesthAnalg 1996; 83:279-85.
  • 11. Glass PSA, Hardman D, Kamiyama Y. Preliminary pharmacokinetics and pharmacodynamics of an ultrashortacting opioid. Remifentanil. Anesth Analg 1993; 77:1031-40.
  • 12. Larijani GE, Goldberg ME.Alfentanil hydrochloride:A new short acting narcotic analgesic for surgical procedures. Clinical Pharmacy 1987; 6: 275-82.
  • 13. Moyer Jr. Alfentail a pharmacolgical and clinical profile. USA: Janssen Pharmaceutica 1987; :l-72.
  • 14. Baley PL, Egan TD, Stanley TH. Intravenous opioid anesthetics. In: Miller RD (ed.). 5th ed. 2000; 1: 314-5; 333-4.
  • 15. Nauta J, deLande S, Koopman D. Anesthetic induction with aifentanil: a new short-acting narcotic analgesic. AnesthAnalg 1982; 61: 267-72.
  • 16. Yonker-Sell AE, Muzi M, Hope WG. Alfentanil modifies the neurocirculatory responses to desflurane. AnesthAnalg 1996 ;82: 162-6
  • 17. Gentil B, Macquin-Mavier I, Harf A Fentanyl-induced airway hyperreactivity in the guinea pig. Eur J Pharmacol 1989; 159: 1815.
  • 18. Cohendy R, Lefrant JY, Laracine M, Rebiere T, Eledjam JJ. Effect of fentanyl on ventilatory resistances during barbiturate general anaesthesia. Br J Anaesth 1992; 69: 5958.
  • 19. Yasuda I, Hirano T, Yusa T, Satoh M. Tracheal constriction by morphine and by fentanyl in man. Anesthesiology 1978; 49: 1179.
  • 20. Cigarini I, Bonnet F, LorinoAM, HarfA, Desmonts JM. Comparison of the effects of fentanyl on respiratory mechanics under propofol or thiopental anaesthesia. ActaAnaesth Scand 1990; 34: 2536.
  • 21. Kayhan Z. Klinik Anestezi. 3. baskı, İstanbul: Logosyayıncılık, 2004; 267, 77.
  • 22. Morgan GE, Michael SM, Murray JM, Larson CP . Clinical Anesthesiology. 3rd ed. New York: Mc Graw Hill, 2002; 47.
  • 23. Tobin MJ. Respiratory monitoring. JAMA 1990; 264: 244-51.
  • 24. JG Reves. Nonvolatile Anesthetic Agents. In: Morgan GE, Michael SM, Murray JM, Larson CP (eds.) Clinical Anesthesiology. New York: Mc Graw Hill, 2002; 167.
  • 25. Kayhan Z. İntravenöz anestezikler. Klinik Anestezi. 3. baskı İstanbul: Logos yayıncılık, 2004; 90.
  • 26. Flacke JW, FlackeWE, Bloor BC, Van EttenAP, Kripke BJ. Histamine release by four narcotics: a double- blind study in humans.AnesthAnalg 1987; 66: 72330.
  • 27. Bowdle TA. Adverse effects of opioid agonists and agonist -antagonists in anaesthesia. Drug Saf 1998; 19: 17389.
  • 28. Neto RPP, Auler JOC Jr. Respiratory mechanical properties during fentanyl and alfentanil anaesthesia. Can JAnaesth 1992; 39: 45865.
  • 29. Bilbault P, Boisson-Bertrand D, Duvivier C, Peslin R, Laxenaire MC. Influence de l'association propofol alfentanil sur les resistances bronchiques du sujet asthmatique (French).Ann FrAnesth Reanim 1991; 10: 2648.
  • 30. Tobias JD, Johnson JO, Sprague K, Johnson G. Effects of rapacuronium on respiratory function during general anesthesia.Anesthesiology 2001; 95: 90812

Evaluation of the Effects of Remifentanyl and Alfentanyl on Spirometric Parameters in Endotracheal Intubations

Year 2006, Volume: 7 Issue: 2, 37 - 41, 01.08.2006

Abstract

Objective: The aim of this study was to evaluate respiratory changes on spirometry which occur in response to endotracheal intubations in patients receiving remifentanyl and alfentanyl. Materials and methods: This is a retrospective study. Spirometric data were derived from anaesthesia monitoring forms in patient files. The study included 40 patients aged between 18 and 60 years. They were assigned into two groups i.e. Group remifentanyl (R) (n=20) and Group alfentanyl (A) (n=20). Group R received intravenous bolus 1 µg/kg remifentanyl before intubations and 0.25 µg/kg/min remifentanyl after intubations and Group A received IV bolus 20 µg/kg alfentanyl before intubations and 1 µg/kg/min alfentanyl after intubations. Peak inspiratory pressure (PIP), plateau pressure (Pplateau), airway resistance (Raw) and pulmonary compliance (C) measured just before and soon after Remifentanyl and Alfentanyl were given and in the intraoperative fifth and tenth minutes were obtained. Results: There was no significant difference in peak inspiratory pressure, plateau pressure and pulmonary compliance between the groups, but the difference in baseline airway resistance between the groups was significant (P

References

  • 1. Conti G, Cosmo DG, Bocci MG, Antonelli M, Ferro G, Costa R, Zito G, Proietti R.Alfentanil does not increase resistance of the respiratory system in ASA I patients ventilated mechanically during general anesthesia. Can JAnesth 2002; 49: 71823
  • 2. Billard V, Cazalaa JB, Servin F, Viviard X. Anesthesie intraveineuse a objektif de concentration. Ann Fr Anesth Reanim 1997; 16: 250-73
  • 3. Vuyk J, Lim T, Engbers FHM, Burm AGL, Vletter AA, Bovill JG. The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women.Anesthesiology 1995; 83: 8-22
  • 4. Smith C, McEwan AL, Jhaveri R, et al. The interaction of fentanyl on the Cp of propofol for of loss consciousness and skin incision. Anesthesiology 1994; 81:820-8
  • 5. James MK, Feldman PL, Schuster SV, Bilotta JM, Brackeen MF, Leighton HJ. Opioid receptor activity of GI 87084B, a novel ultra-short acting analgesic, in isolated tissues. J Pharmacol Exp Ther 1991; 259:712- 8.
  • 6. Barash PG, Cullen BF, Stoelting RK. Handbook of Clinical Anesthesia, ingilizce 3. baskıdan Türkçe'ye cevrilmiş, 3. baskı (Çeviren: Elar Z.) İstanbul: Logos yayıncılık, 1999; 122-3.
  • 7. Glass PSA, Gan TJ, Howel S. A review of the pharmacokinetics and pharmacodynamics of remifentanil.AnaesthAnalg 1999; 89: 7-14.
  • 8. Bailey PL, Egan TD, Stanley TH. Intravenous Opoid Anesthetica. 5th ed. New York: Churchill Livingstone, 2000:273-377.
  • 9. Albrecht S, Schuttler J, Yarmush J. Postoperative pain management after intraoperative remifentanil. Anesth Analg 1999; 89 :40-5.
  • 10. Hogue CW Jr, Bowdle TA, O'Leary C. A multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery. AnesthAnalg 1996; 83:279-85.
  • 11. Glass PSA, Hardman D, Kamiyama Y. Preliminary pharmacokinetics and pharmacodynamics of an ultrashortacting opioid. Remifentanil. Anesth Analg 1993; 77:1031-40.
  • 12. Larijani GE, Goldberg ME.Alfentanil hydrochloride:A new short acting narcotic analgesic for surgical procedures. Clinical Pharmacy 1987; 6: 275-82.
  • 13. Moyer Jr. Alfentail a pharmacolgical and clinical profile. USA: Janssen Pharmaceutica 1987; :l-72.
  • 14. Baley PL, Egan TD, Stanley TH. Intravenous opioid anesthetics. In: Miller RD (ed.). 5th ed. 2000; 1: 314-5; 333-4.
  • 15. Nauta J, deLande S, Koopman D. Anesthetic induction with aifentanil: a new short-acting narcotic analgesic. AnesthAnalg 1982; 61: 267-72.
  • 16. Yonker-Sell AE, Muzi M, Hope WG. Alfentanil modifies the neurocirculatory responses to desflurane. AnesthAnalg 1996 ;82: 162-6
  • 17. Gentil B, Macquin-Mavier I, Harf A Fentanyl-induced airway hyperreactivity in the guinea pig. Eur J Pharmacol 1989; 159: 1815.
  • 18. Cohendy R, Lefrant JY, Laracine M, Rebiere T, Eledjam JJ. Effect of fentanyl on ventilatory resistances during barbiturate general anaesthesia. Br J Anaesth 1992; 69: 5958.
  • 19. Yasuda I, Hirano T, Yusa T, Satoh M. Tracheal constriction by morphine and by fentanyl in man. Anesthesiology 1978; 49: 1179.
  • 20. Cigarini I, Bonnet F, LorinoAM, HarfA, Desmonts JM. Comparison of the effects of fentanyl on respiratory mechanics under propofol or thiopental anaesthesia. ActaAnaesth Scand 1990; 34: 2536.
  • 21. Kayhan Z. Klinik Anestezi. 3. baskı, İstanbul: Logosyayıncılık, 2004; 267, 77.
  • 22. Morgan GE, Michael SM, Murray JM, Larson CP . Clinical Anesthesiology. 3rd ed. New York: Mc Graw Hill, 2002; 47.
  • 23. Tobin MJ. Respiratory monitoring. JAMA 1990; 264: 244-51.
  • 24. JG Reves. Nonvolatile Anesthetic Agents. In: Morgan GE, Michael SM, Murray JM, Larson CP (eds.) Clinical Anesthesiology. New York: Mc Graw Hill, 2002; 167.
  • 25. Kayhan Z. İntravenöz anestezikler. Klinik Anestezi. 3. baskı İstanbul: Logos yayıncılık, 2004; 90.
  • 26. Flacke JW, FlackeWE, Bloor BC, Van EttenAP, Kripke BJ. Histamine release by four narcotics: a double- blind study in humans.AnesthAnalg 1987; 66: 72330.
  • 27. Bowdle TA. Adverse effects of opioid agonists and agonist -antagonists in anaesthesia. Drug Saf 1998; 19: 17389.
  • 28. Neto RPP, Auler JOC Jr. Respiratory mechanical properties during fentanyl and alfentanil anaesthesia. Can JAnaesth 1992; 39: 45865.
  • 29. Bilbault P, Boisson-Bertrand D, Duvivier C, Peslin R, Laxenaire MC. Influence de l'association propofol alfentanil sur les resistances bronchiques du sujet asthmatique (French).Ann FrAnesth Reanim 1991; 10: 2648.
  • 30. Tobias JD, Johnson JO, Sprague K, Johnson G. Effects of rapacuronium on respiratory function during general anesthesia.Anesthesiology 2001; 95: 90812
There are 30 citations in total.

Details

Other ID JA94SN66EK
Journal Section Research Article
Authors

Erdal Gezer This is me

Selda Şen This is me

Bakiye Uğur This is me

Osman Nuri Aydın This is me

Mustafa Oğurlu This is me

Feray Gürsoy This is me

Publication Date August 1, 2006
Published in Issue Year 2006 Volume: 7 Issue: 2

Cite

EndNote Gezer E, Şen S, Uğur B, Aydın ON, Oğurlu M, Gürsoy F (August 1, 2006) Evaluation of the Effects of Remifentanyl and Alfentanyl on Spirometric Parameters in Endotracheal Intubations. Meandros Medical And Dental Journal 7 2 37–41.