The Application of Remifentanil in Transsphenoidal Surgery / 中国现代医生

ABSTRACT

Objective In this prospective study,we evaluated the effects of remifentsni]in ASA Ⅰ～Ⅱ patients undergoing transsphenoidal surgery. Methods After the induction of anesthesia,patients were randomly allocated to the Isoflurane(n=11,isoflurane (MAP)increased>80mmHg during maximal dosage of isoflurane or remifentanil,esmolol was administered.At the end of anesthesia,extubation and awakening times,respiratory rate,SpO2,MAP,heart rate and adverse effects were recorded. Results Hemodynamics and bleeding(minimal, mild, moderate, severe) were not different between groups. Esmolol was administered to 7 patients in the isoflurane group,and 3 patients in the remifentanil group(P<0.01). The dose of esmolol was larger in the isoflurane group(1.1±0.7 versus 0.4±0.5mg/kg,P<0.05). Time to extubation did not differ,whereas time to follow commands was shorter in Remifentanil patients (16 ±7versus 10 ± 1min,P <0.01). No adverse effects occurred in the early post-operative period. Conclusion Stable bemodynamics and the rapid emergence and the absence of postoperative respiratory depression seem to be the chief benefits from the use of balanced anesthesia with remifentanil in elective transsphenoidal surgery.