The Effects of Propofol-Remifentanil Vs Midazolam-Remifentanil on Hemodynamic Stability during Stapedectomy: A Randomized Clinical Trial
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 4 No. 1 (2018),
7 Mordad 2018
,
Page e4
https://doi.org/10.22037/orlfps.v4i1.22389
Abstract
Background: One of the essential components during stapedectomy is a good cooperation between patient and surgeon. Remifentanil is commonly used short – acting opioid to assess the results during the procedure.
Purpose: The aim of this study is to investigate the effects of propofol- remifentanil and midazolam -remifentanil on hemodynamic parameters intra- Stapedectomy.
Methods: In this randomized, double-blinded trial, 36 patients with otosclerosis were evaluated in two equal groups, which received propofol- remifentanil and midazolam- remifentanil each. We recorded cardio-respiratory parameters, side effects and intra-operative cooperation of the patients.
Results: There was a statistically significant difference in blood pressure reduction between two groups. The severity of the bleeding and desirable cooperation of patients in midazolam- based regimen was better than propofol- based regimen (p- value= 0.01 and 0.02 respectively). The average operative time in patients who received propofol was about 15 minutes more than the other group (p- value=0.01).
Conclusion: The midazolam - remifentanil is more appropriate sedative, because it provides hemodynamic stability and a better cooperation of patient intra - stapedectomy.
- Stapedectomy
- Remifentanil
- Midazolam
- Propofol
How to Cite
References
House JW, Toh EH, Perez A. Diving after stapedectomy: clinical experience and recommendations. Otolaryngol Head Neck Surg. 2001; 125(4):356-60.
Tos M. Complications after stapedectomy. Surgical solutions for conductive hearing loss Thieme, New York. 2000:166-74.
Uppal, S., Y. Bajaj, and A. P. Coates worth. "Otosclerosis 2: the medical management of otosclerosis." International journal of clinical practice 64.2 (2010): 256-265
Edussuriya B, Goonasekera C, Rajapakse M, Rajapakse V, Jayasooriya D. Middle ear surgery under local anaesthesia and sedation. The Ceylon medical journal. 1997;42(2):75-7.
Zuo X-L, Li Z, Liu X-P, Li C-Q, Ji R, Wang P, et al. Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: A randomized trial. World journal of gastroenterology: WJG. 2012; 18(15):1814.
Guignard B, Menigaux C, Dupont X, Fletcher D, Chauvin M. The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg 2000; 90:161–167.
Lim YS, Kang DH, Kim SH, Jang TH, Kim KH, Ryu SJ, et al. The cardiovascular effects of midazolam co-induction to propofol for induction in aged patients. Korean J Anesthesiol. 2012; 62(6):536-542. http://dx.doi.org/10.4097/kjae.2012.62.6.536
McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc. 2008;67(6):910-23. doi: 10.1016/j.gie.2007.12.046
Daabiss M. American Society of Anesthesiologists physical status classification. Indian J Anaesth. 2011 Mar-Apr; 55(2): 111–115. doi: 10.4103/0019-5049.79879
White PF, Negus JB. Sedative infusions during local and regional anesthesia: a comparison of midazolarn and propofol. Journal of clinical anesthesia. 1991;3(1):32-9.
Khurana P, Agarwal A, Verma R, Gupta P. Comparison of midazolam and propofol for BIS-guided sedation during regional Anaesthesia. Indian journal of anaesthesia. 2009;53(6):662.
Pratila MG, Fischer ME, Alagesan R, Alagesan R, Reinsel RA, Pratilas D. Propofol versus midazolam for monitored sedation: a comparison of intraoperative and recovery parameters. Journal of clinical anesthesia. 1993;5(4):268-74
Cillo JE, LR, DMD, Buffalo, NY Propofol anesthesia for outpatient oral and maxillofacial surgery. Oral Surgery, Oral Medicine, Oral Pathology. 1999;87(5):530-8.
Vuyk J. Clinical interpretation of pharmacokinetic and pharmacodynamic propofol-opioid interactions. Acta Anaesthesiologica Belgica. 2000;52(4):445-51
Mesolella M, Lamarca S, Galli V, Ricciardiello F, Cavaliere M, Iengo M. Use of Remifentanil for sedo-analgesia in stapedotomy: personal experience. Acta Otorhinolaryngol Ital. 2004; 24:315-20.
Magarey JM. Propofol or midazolam—which is best for the sedation of adult ventilated patients in intensive care units? A systematic review. Australian Critical Care. 2001;14(4):147-54 anesthesia. 1993;7(2):142-7
Roekaerts PM, Huygen FJ, de Lange S. Infusion of propofol versus midazolam for sedation in the intensive care unit following coronary artery surgery. Journal of cardiothoracic and vascular anesthesia. 1993; 7(2):142-
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