[PMID]: | 28178175 |
[Au] Autor: | Won YJ; Lim BG; Yeo GE; Lee MK; Lee DK; Kim H; Lee IO; Kong MH |
[Ad] Endereço: | Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. |
[Ti] Título: | The effect of nicardipine on the surgical pleth index during thyroidectomy under general anesthesia: A prospective double-blind randomized controlled trial. |
[So] Source: | Medicine (Baltimore);96(6):e6154, 2017 Feb. |
[Is] ISSN: | 1536-5964 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. METHODS: Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50). The infusion of nicardipine or remifentanil was started before the 1st incision and adjusted to keep mean blood pressure (MBP) within ±20% of the preoperative value. SPI, BIS, end-tidal desflurane concentration (EtDes), MBP, and heart rate were recorded at 2.5 minute intervals from the 1st incision to the end of surgery. Extubation and recovery times, pain score/rescue ketorolac consumption, and adverse events in postanesthesia care unit (PACU) were recorded. RESULTS: The trend of SPI during surgery was comparable between the 2 groups (P = 0.804), although the heart rates in group N were significantly higher than those in group R (P = 0.040). The patient characteristics, trends of BIS, EtDes, and MBP during surgery, extubation and recovery times, and incidence of nausea/vomiting were comparable between the groups. Group N had significantly lower pain scores and rescue ketorolac consumption at PACU. CONCLUSION: SPI was comparable between patients receiving nicardipine or remifentanil infusion during thyroidectomy under general anesthesia, which suggests that the administration of nicardipine may confound the interpretation of SPI values during general anesthesia. CLINICAL TRIAL REGISTRATION: This trial was registered in the UMIN clinical trials registry (unique trial number: UMIN000019058; registration number: R000022028; principal investigator's name: Young Ju Won; date of registration: September 17, 2015). |
[Mh] Termos MeSH primário: |
Frequência Cardíaca/efeitos dos fármacos Nicardipino/farmacologia Dor Pós-Operatória/tratamento farmacológico Fotopletismografia/efeitos dos fármacos Tireoidectomia/métodos Vasodilatadores/farmacologia
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[Mh] Termos MeSH secundário: |
Analgésicos Opioides/uso terapêutico Anestesia Geral/métodos Método Duplo-Cego Feminino Seres Humanos Masculino Piperidinas/uso terapêutico Náusea e Vômito Pós-Operatório/tratamento farmacológico Estudos Prospectivos
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Nm] Nome de substância:
| 0 (Analgesics, Opioid); 0 (Piperidines); 0 (Vasodilator Agents); CZ5312222S (Nicardipine); P10582JYYK (remifentanil) |
[Em] Mês de entrada: | 1702 |
[Cu] Atualização por classe: | 170227 |
[Lr] Data última revisão:
| 170227 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 170209 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1097/MD.0000000000006154 |
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