Abstract | BACKGROUND: METHODS: After institutional approval and informed patient consent were obtained, 23 patients scheduled to undergo supratentorial tumor surgery were randomly assigned to remifentanil or fentanyl infusion groups in a double-blinded manner. Midazolam, thiopental, and pancuronium induction was followed by equipotent narcotic loading infusions of remifentanil (1 microg x kg(-1) x min(-1)) or fentanyl (2 microg x kg(-1) x min(-1)) for 5-10 min. Patients were ventilated with 2:1 nitrous oxideoxygen, and opioid rates were reduced and then titrated to a stable hemodynamic effect. After dural exposure, CBF was measured by the intravenous 133xenon technique at normocapnia and hypocapnia. Reactivity of CBF to carbon dioxide was calculated as the absolute increase in CBF per millimeters of mercury increase in the partial pressure of carbon dioxide (PaCO2). Data were analyzed by repeated-measures analysis of variance, unpaired Student's t-tests, or contingency analysis. RESULTS: In the remifentanil group (n = 10), CBF decreased from 36+/-11 to 27+/-8 ml x 100 g(-1) x min(-1) as PaCO2 decreased from 33+/-5 to 25+/-2 mmHg. In the fentanyl group (n = 8), CBF decreased from 37+/-11 to 25+/-6 ml x 100 g(-1) x min(-1) as PaCO2 decreased from 34+/-3 to 25+/-3 mmHg. Absolute carbon dioxide reactivity was preserved with both agents: 1+/-1.2 ml x 100 g(-1) x min(-1) x mmHg(-1) for remifentanil and 1.5+/-0.5 ml x 100 g(-1) x min(-1) x mmHg(-1) for fentanyl (P = 0.318). CONCLUSION:
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Authors | N D Ostapkovich, K Z Baker, P Fogarty-Mack, M B Sisti, W L Young |
Journal | Anesthesiology
(Anesthesiology)
Vol. 89
Issue 2
Pg. 358-63
(Aug 1998)
ISSN: 0003-3022 [Print] United States |
PMID | 9710393
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anesthetics, Inhalation
- Anesthetics, Intravenous
- Piperidines
- Carbon Dioxide
- Nitrous Oxide
- Remifentanil
- Fentanyl
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Topics |
- Adult
- Anesthesia, General
- Anesthetics, Inhalation
- Anesthetics, Intravenous
- Carbon Dioxide
(blood)
- Cerebrovascular Circulation
(drug effects)
- Double-Blind Method
- Female
- Fentanyl
- Humans
- Male
- Middle Aged
- Nitrous Oxide
- Piperidines
- Remifentanil
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