Hashemiyazdi Seyedeh Hamideh, Masoudifar Mehrdad, Rahimi Zahra, Honarmand Azim, Aryafar Mohamad
Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Anesthesiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Ann Med Surg (Lond). 2022 Sep 22;82:104761. doi: 10.1016/j.amsu.2022.104761. eCollection 2022 Oct.
Spinal fusion surgery completely prevents movement or friction between the two vertebrae. Remifentanil, a selective drug agonist, suppresses and decreases the vasomotor system upon release of histamine. In this study, the efficacy of remifentanil infusion at doses of 0.1 and 0.3 μg/kg/min in the control of low blood pressure was compared.
In this randomized clinical trial, 110 candidates for selective spinal fusion surgery were entered and randomized into 2 groups. The first group received 0.1 μg/kg/min and in the second group 0.3 μg/kg/min remifentanil. The systolic and diastolic blood pressure, pulse rate, SPO2, and surgeon's satisfaction were measured and compared between groups.
the systolic blood pressure was significantly lower in patients receiving 0.3 μg of remifentanil by the time 30, 45, 60, and 90 min during the surgeries (P < 0.05). No significant difference was observed in terms of PR (P = 0.19) and SPO2 (P = 0.41) between the two groups. We also observed significantly higher duration of surgeries (P = 0.002), duration of anesthesia (P = 0.009), significantly higher bleeding volume (P < 0.001), higher fluid intake (P = 0.01) and higher transfused blood (P = 0.01) in patients that received 0.1 μg remifentanil compared to other patients.
Here we showed that administration of 0.3 μg/kg/min remifentanil was associated with significantly lower systolic blood pressure during the surgeries. On the other hand, patients that received 0.1 μg/kg/min remifentanil had significantly higher duration of surgeries, duration of anesthesia, significantly higher bleeding volume, higher fluid intake, and also higher transfused blood.
脊柱融合手术可完全防止两个椎体之间的移动或摩擦。瑞芬太尼是一种选择性药物激动剂，在组胺释放时会抑制并降低血管运动系统。在本研究中，比较了以0.1和0.3μg/kg/分钟的剂量输注瑞芬太尼对控制低血压的疗效。
在这项随机临床试验中，110名选择性脊柱融合手术的候选者被纳入并随机分为2组。第一组接受0.1μg/kg/分钟的瑞芬太尼，第二组接受0.3μg/kg/分钟的瑞芬太尼。测量并比较两组的收缩压和舒张压、脉搏率、SPO2以及外科医生的满意度。
在手术过程中的30、45、60和90分钟时，接受0.3μg瑞芬太尼的患者收缩压显著更低（P<0.05）。两组之间在PR（P=0.19）和SPO2（P=0.41）方面未观察到显著差异。我们还观察到，与其他患者相比，接受0.1μg瑞芬太尼的患者手术时间显著更长（P=0.002）、麻醉时间显著更长（P=0.009）、出血量显著更多（P<0.001）、液体摄入量更高（P=0.01）以及输血量更高（P=0.01）。
我们在此表明，输注0.3μg/kg/分钟的瑞芬太尼与手术期间显著更低的收缩压相关。另一方面，接受0.1μg/kg/分钟瑞芬太尼的患者手术时间、麻醉时间显著更长，出血量、液体摄入量以及输血量也显著更高。
