AI Summary & Key Takeaways
AI InsightRemifentanil was infused at 0.3 pg kg"1 min1 maintaining bispectral index at 40-60 in both groups after induction dosage of 1 pg kg"1 Hemodynamics, propofol consumption; time passed up to extubation, an Aldrete score > 9 and first requirement of an analgesic, together with patient satisfaction and side effects were documented.Results: Mean arterial pressure was significantly higher at incision, at intraoperative 25 min, while heart rate increased significantly at the time of intubation, and incision and at 5., 10., 15., 20., 25., 30., 40 min intraoperatively in Group H (p 9, and propofol consumption were increased significantly in Group H (p0.05).Conclusion: Manually controlled infusion of propofol; calculated according to total body weight may be preferred safely in obese patients; as it provides sufficient anesthetic depth, attenuating cardiovascular changes, propofol consumption, and prolonging the time to the need for a rescue analgesic in comparison to target controlled infusion.
📌 3 Key Takeaways
Abstract
Aim: We aimed to compare the effects of propofol dosages calculated according to total body weight, and administered via target or manually controlled infusion on hemodynamics, propofol consumption, and recovery in obese laparoscopic cholecystectomy patients.Material and Method: After obtaining the approval and informed consent of The Ethics Committee, 60 ASA I-1II patients with body mass indexes of 30-40 kg m 2 were allocated randomly into two equal groups according to method of propofol infus|on as target (H) or manually (M) controlled. In Group H, anesthesia induction and maintanence was managed with propofol at plasma target concentrations of 2.5-3.5 pg mL"1. Group M received propofol as an maintenance dose of 2 mg kg1 and then a bolus infusion of 3-10 mg kg"1 hr1. Remifentanil was infused at 0.3 pg kg"1 min1 maintaining bispectral index at 40-60 in both groups after induction dosage of 1 pg kg"1 Hemodynamics, propofol consumption; time passed up to extubation, an Aldrete score > 9 and first requirement of an analgesic, together with patient satisfaction and side effects were documented.Results: Mean arterial pressure was significantly higher at incision, at intraoperative 25 min, while heart rate increased significantly at the time of intubation, and incision and at 5., 10., 15., 20., 25., 30., 40 min intraoperatively in Group H (p 9, and propofol consumption were increased significantly in Group H (p0.05).Conclusion: Manually controlled infusion of propofol; calculated according to total body weight may be preferred safely in obese patients; as it provides sufficient anesthetic depth, attenuating cardiovascular changes, propofol consumption, and prolonging the time to the need for a rescue analgesic in comparison to target controlled infusion.
Özet
Amaç: Bu çalışmada; obez, laparoskopik kolesistektomi olgularında, total vücut ağırlığına göre hesaplanan propofolün hedef veya manüel kontrollü infüzyon yöntemi ile uygulanmasının hemodinami, propofol tüketimi ve derlenme üzerine etkilerini karşılaştırmayı amaçladık.Gereç ve Yöntem: Çalışmamızda etik kurul onayı ve yazılı izinleri alınan, vücut kitle indeksi 30-40 kg m-2 olan, ASA I-III grubunda 60 olgu, propofolün total vücut ağırlığına göre, hedef veya manüel kontrollü infüzyon ile verilmesine göre rasgele 2 eşit gruba ayrıldı. Grup H’de propofol için indüksiyon ve sonrasında plazma hedef konsantrasyonu 2.5-3.5 μg mL-1 olacak şekilde ve remifentanil 1 μg kg-1 bolus uygulandıktan sonra; Grup M’de indüksiyonda propofol 2 mg kg-1, remifentanil 1 μg kg-1 bolus uygulandıktan sonra, idamede propofol infüzyon hızı 3-10 mg kg-1 sa-1 ve sonrasında her iki grupta, bispektral indeks 40-60 arasında olacak şekilde; remifentanil infüzyonu 0.3 μg kg-1 dk-1 uygulandı. Hemodinami, propofol tüketimi, ekstübasyon, Aldrete skoru ≥ 9 olma ve ilk analjezik gereksinim süresi, yan etkiler ve hasta memnuniyeti değerlendirildi. Bulgular: Ortalama arter basıncı, cerrahi insizyonda ve intraoperatif 25. dk.’da, kalp atım hızı, entübasyonda, cerrahi insizyonda ve intraoperatif 5., 10., 15., 20., 25., 30., 40. dk.’da Grup H’de Grup M’ye göre anlamlı yüksekti (p