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Is Remifentanil effective in single bolus anaesthesia during the testing of implanted automatic cardioverter-defibrillator and ordinary cardioversion?: A-57

Michalska-Krzanowska, G.; Stasiak-Pikula, E.; Makowski, A.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 15
Ambulatory Anaesthesia
Free

Department of Anaesthesiology and Intensive Care, Pomeranian Medical University, Szczecin, Poland

Background and Goal of Study: Cardioversion (CA) is a single painful stimulus and anaesthesia in these cases must be effective and short. The perfect analgesic drug seems to be Remifentanil (RE), with quick acting short activity, being non cumulative μ-1 receptor agonist. In this study we estimated the usefulness of RE in single bolus anaesthesia (AN).

Materials and Methods: After written consent obtained from 27 patients, ASA II/III they were anaesthetised for CA. Anaesthesia was maintained with Hypnomidat 0.1 mm/kg and RE 0.9 μg/kg in single intravenous bolus for 45secs. Immediately after induction CA with stimuli of 3J/kg was performed. During the procedure we registered systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and saturation (SaO2) before a AN (I), 2 mins after induction (II) and after recovery (III). We measured the time to consciousness, then pain with 0-3 point VAS scale.

Results: The average time to awareness was 4.7 min. In 18.5% of the cases we had to ventilate patients with a facial mask. In 14.8% HR was less then 50 beats/min. We observed hypotension <90 mmHg in 14.8% of cases. On average patients estimated their pain to be at 1 point. The rest of the parameters are shown as mean and SD in table.

Table

Table

Conclusion: Anaesthesia with Remifentanil is safe, gives hemodynamic stabilisation and allows efficient spontaneous ventilation in the majority of patients. After the procedure patients regain consciousness quickly and without pain.

© 2005 European Society of Anaesthesiology