Korean journal of anesthesiology
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Korean J Anesthesiol · Aug 2012
Effect of a single bolus of methylene blue prophylaxis on vasopressor and transfusion requirement in infective endocarditis patients undergoing cardiac surgery.
The accentuated nitric oxide (NO) release that is induced by the systemic inflammatory response associated with infective endocarditis (IE) and cardiopulmonary bypass (CPB) may result in catecholamine refractory hypotension (vasoplegia) and increased transfusion requirement due to platelet inhibition. Methylene blue (MB) is an inhibitory drug of inducible NO. We aimed to evaluate the effect of prophylactic MB administration before CPB on vasopressor and transfusion requirements in patients with IE undergoing valvular heart surgery (VHS). ⋯ In IE patients undergoing VHS, prophylactic MB administration before CPB did not confer significant benefits in terms of vasopressor requirements and hemodynamic parameters, but it was associated with a significant reduction in transfusion requirement.
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Korean J Anesthesiol · Aug 2012
Comparison of dexmedetomidine and remifentanil for attenuation of hemodynamic responses to laryngoscopy and tracheal intubation.
This study was designed to compare the effect of dexmedetomidine and remifentanil used in anesthetic induction on hemodynamic change after direct laryngoscopy and tracheal intubation. ⋯ In healthy normotensive patients, the use of dexmedetomidine during anesthetic induction suppressed a decrease in blood pressure due to anesthetic induction and blunted the hemodynamic responses to endotracheal intubation.
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Korean J Anesthesiol · Aug 2012
Remifentanil used as adjuvant in general anesthesia for spinal fusion does not exhibit acute opioid tolerance.
Although acute tolerance to opioids, especially to remifentanil, has been demonstrated consistently in animal studies, the results of clinical trials in humans are controversial. The aim of this study was to determine whether intraoperative infusions of remifentanil used as an adjuvant in general anesthesia result in acute tolerance, an event manifested by increased postoperative pain and a higher opioid requirement than usual. ⋯ Remifentanil as an adjuvant to sevoflurane or propofol in general anesthesia for adults having surgery for spinal fusion does not appear to cause acute opioid tolerance or hyperalgesia in patients. However, further studies are needed to elucidate whether sevoflurane and propofol exert a clinically significant effect on opioid-induced tolerance or hyperalgesia and whether this effect is related to the age of the patient, the dose and duration of remifentanil given and the intensity of pain experienced postoperatively.
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Korean J Anesthesiol · Aug 2012
The optimal effect-site concentration of remifentanil to attenuate the pain caused by propofol.
The injection pain of propofol is a frequent and well-known adverse effect. This study was designed to determine the optimal effect-site concentration of remifentanil for minimizing injection pain during induction with propofol. ⋯ Maintaining 3.78 ng/ml EC of remifentanil during induction with propofol attenuate propofol injection pain without serious adverse events in female patients undergoing general anesthesia and this method may provide the patient's comfort without preparing other drugs for pain relief.
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Korean J Anesthesiol · Jul 2012
A target-controlled infusion regimen for reducing remifentanil-induced coughs.
This study evaluates the effectiveness of the target-controlled infusion (TCI) of remifentanil through stepwise increases in the effect-site concentration (C(eff)) in preventing coughs. ⋯ Stepwise increases in the TCI of remifentanil reduced the incidence of remifentanil-induced coughing, and the three-step increase in TCI nearly eliminated remifentanil-induced coughing.