A Comparison of Post-operative Recovery Between Remifentanil-propofol and Remifentanil-desflurane Anesthesia Guided by Bispectral Index Monitoring
Overview
- Phase
- Phase 4
- Intervention
- Propofol
- Conditions
- Delayed Emergence From Anesthesia
- Sponsor
- Federal University of Minas Gerais
- Enrollment
- 40
- Primary Endpoint
- Extubation Time
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Bispectral monitoring anesthesia with remifentanil-desflurane has a better post-operative recovery than remifentanil-propofol.
Detailed Description
It is a randomized, double blind study, involving 40 adult female patients submitted to general anesthesia. The patients were distributed into 2 groups: remifentanil-propofol-based anesthesia and remifentanil-desflurane-based anesthesia groups. Bispectral index (BIS) monitoring guided the anesthesia by setting target BIS range value between 40 and 60. Anesthetics were adjusted to reached that. Primary outcome was: extubation time (time from anesthetic discontinuation to endotracheal tube cuff). Secondary measured outcomes: intra-operative cardiovascular drug use; time to follow command before extubation; protective airway reflex recovery time after extubation. Protective airway reflex test recovery was performed at predetermined time intervals (2, 6, 14, 22 and 30 minutes) from the time to follow a standard command until the first demonstrated ability to swallow 20 ml of water in an upright position.Post-anesthesia care unit recovery data were also recorded: Ramsay sedation scale; vital signs, post-operative pain; morphine consumption.
Investigators
Renato Santiago Gomez
Head of surgery department of the Medical School of the Federal University of Minas Gerais
Federal University of Minas Gerais
Eligibility Criteria
Inclusion Criteria
- •Female patients over 18 years old classified by the American Society of Anesthesiologists as physical status I or II, undergoing elective breast surgery with general anesthesia.
Exclusion Criteria
- •History of: illegal drug and alcohol abuse
- •Pregnancy on course or suspicion of
- •Neuromuscular disorders
- •Cerebral vascular disease
- •Dysphagia
- •Dysphonia
- •Gastroesophageal reflux disease
- •Previous larynx and/or upper gastrointestinal tract surgery
- •Allergy to any drug to be used and malignant hyperthermia.
- •Patients who develop hemodynamic instability in the surgery and need blood transfusion were excluded from the study.
Arms & Interventions
REM-PRO
Total intravenous anesthesia with remifentanil and propofol, target controlled infusion based on Minto's and Marsh's pharmacokinetic models.
Intervention: Propofol
REM-DES
Balanced anesthesia with remifentanil target controlled infusion based on Minto's pharmacokinetic model and desflurane.
Intervention: Desflurane
Outcomes
Primary Outcomes
Extubation Time
Time Frame: Time from anesthetic discontinuation to endotracheal tube cuff deflation
Time from anesthetic discontinuation to endotracheal tube cuff deflation