AI Summary & Key Takeaways
AI InsightAs a result, in order to prevent the hemodynamic effects of tracheal entubation, 2$mu$g/kg remifentanyl is a good alternative to 30$mu$g/kg alfentanyl but 1.25$mu$g/kg remifentanyl is not enough to prevent this effect, in addition, in this study, we recognized that because of the respiratory system depression effect of the remifentanyl, with dosage of 1.25$mu$g/kg and above even in slow adminastration should not be given to patients with spontaneous respiration.
📌 3 Key Takeaways
Abstract
We studied the effects of bolus of fentanyl, alfetanyl and two different doses of remifentanyl on hemodynamic affect because of entubation. A hundred patients enrolled in this study with age 18-65 and ASA l-ll. The patients with cardiopulmonary, renal and hepatic problems and mallonpaty H-IV and obesity were excluded. Patiets were randomized in to five groups. Each group consists of 20 patients. 0.07 mg/kg midazolam were administered as a premedication. 25 $mu$/kg remifentanyl to first group, 2 $mu$g/kg remifentanyl to second group, 3$mu$g/kg fentanyl to third group, 30$mu$g/kg alfentanyl to fourth group, 10 ml isotonic solution as placebo to fifth goup were given in less than 60 seconds. Intubation was achieved by giving 5mg/Kg tiyopental and 0.6 mg/kg rocuronyum. After one minute, entubation was done. Levels of SAP, DAP, MAP, HR, and SaO2 of patients recorded. As a result, in order to prevent the hemodynamic effects of tracheal entubation, 2$mu$g/kg remifentanyl is a good alternative to 30$mu$g/kg alfentanyl but 1.25$mu$g/kg remifentanyl is not enough to prevent this effect, in addition, in this study, we recognized that because of the respiratory system depression effect of the remifentanyl, with dosage of 1.25$mu$g/kg and above even in slow adminastration should not be given to patients with spontaneous respiration.
Özet
Entübasyonun neden olduğu hemodinamik yanıtı önlemede fentanil, alfentanil ve iki farklı remifentanil dozunun bolus uygulamalarının etkilerini karşılaştırdık. ASA 1-11,18-65 yaş arası, elektif 100 hasta çalışmaya alındı. Kardiyovasküler, pulmoner, renal, hepatik hastalığı olan mallampati III-IV ve obes hastalar çalışmaya alınmadı. Rastgele 20'Ii beş gruba ayrılan hastalar 0,07 mg/kg midazolam ile premedike edildi, indüksiyondan önce 1.gruba 1,25 $mu$g/kg remifentanil, 2.gruba 2 $mu$g/kg remifentanil, S.gruba 3 $mu$g/kg fentanil, 4.gruba 30 $mu$g/kg alfentanil, 5.gruba (plasebo) 10 ml. serum fizyolojil 60 sn.'den hızlı olmayacak şekilde verildi. 5 mg/kg tiyopen-tal ve 0,6 mg/kg rokuronyum ile sağlandı.1 dk. sonra entübasyon gerçekleştirildi. Hastaların SAB, DAB, OAB,KAH ve SaO2 değerleri kaydedildi. Sonuç olarak; trakeal entübasyona hemodinamik yanıtı önlemede 2 $mu$g/kg remifentanilin, 30 $mu$g/kg alfentanile iyi bir alternatif olduğgu, 1,25 $mu$g/kg remifentanilin ise bu yanıtı önlemede yetersiz kaldığı, ayrıca remifentanilin çalışmamızda gözlediğimiz güçlü solunumu deprese edici etkisinden dolayı, 1,25 $mu$g/kg ve üzerindeki dozlarında, yavaş bolus uygulamada dahi spontan solumdaki hastalarda uygun olmadığı kararına vardık.