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Article: A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice

TitleA clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice
Authors
Issue Date2010
PublisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AAS
Citation
Acta Anaesthesiologica Scandinavica, 2010, v. 54 n. 7, p. 871-877 How to Cite?
AbstractBackground: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. Methods: Forty-two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were studied. Anesthesia was induced with propofol (1.5-2 mg/kg) and remifentanil (2 μg/kg). After tracheal intubation, anesthesia was titrated using isoflurane in oxygen-enriched air, adjusted to maintain a bispectral index (BIS) value of 46-54. Ephedrine, atropine and remifentanil were used to maintain hemodynamic parameters within 30% of the baseline. The mean arterial blood pressure (MAP), heart rate (HR), drug doses and the time taken to recover from anesthesia were recorded. Results: Demographic data, duration and BIS values were similar in both groups. Anesthesia induction and maintenance were associated with more hemodynamic instability in the patients with jaundice and they received more ephedrine and atropine and less remifentanil and isoflurane (51.1±24.2 vs. 84.6±20.3 mg/min; P for all <0.05) than control patients. Despite less anesthetic use, the time to recovery and extubation was significantly longer than that in control. Conclusion: Patients with obstructive jaundice have an increased sensitivity to isoflurane, more hypotension and bradycardia during anesthesia induction and maintenance and a prolonged recovery time compared with controls. © 2010 The Acta Anaesthesiologica Scandinavica Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/142302
ISSN
2015 Impact Factor: 2.049
2015 SCImago Journal Rankings: 1.020
ISI Accession Number ID
Funding AgencyGrant Number
National Natural Science Foundation of China (NSFC)30600584
Funding Information:

This study was supported by a grant from the National Natural Science Foundation of China (NSFC, No.30600584).

References

 

DC FieldValueLanguage
dc.contributor.authorYang, LQen_HK
dc.contributor.authorSong, JCen_HK
dc.contributor.authorIrwin, MGen_HK
dc.contributor.authorSong, JGen_HK
dc.contributor.authorSun, YMen_HK
dc.contributor.authorYu, WFen_HK
dc.date.accessioned2011-10-28T02:42:25Z-
dc.date.available2011-10-28T02:42:25Z-
dc.date.issued2010en_HK
dc.identifier.citationActa Anaesthesiologica Scandinavica, 2010, v. 54 n. 7, p. 871-877en_HK
dc.identifier.issn0001-5172en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142302-
dc.description.abstractBackground: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. Methods: Forty-two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were studied. Anesthesia was induced with propofol (1.5-2 mg/kg) and remifentanil (2 μg/kg). After tracheal intubation, anesthesia was titrated using isoflurane in oxygen-enriched air, adjusted to maintain a bispectral index (BIS) value of 46-54. Ephedrine, atropine and remifentanil were used to maintain hemodynamic parameters within 30% of the baseline. The mean arterial blood pressure (MAP), heart rate (HR), drug doses and the time taken to recover from anesthesia were recorded. Results: Demographic data, duration and BIS values were similar in both groups. Anesthesia induction and maintenance were associated with more hemodynamic instability in the patients with jaundice and they received more ephedrine and atropine and less remifentanil and isoflurane (51.1±24.2 vs. 84.6±20.3 mg/min; P for all <0.05) than control patients. Despite less anesthetic use, the time to recovery and extubation was significantly longer than that in control. Conclusion: Patients with obstructive jaundice have an increased sensitivity to isoflurane, more hypotension and bradycardia during anesthesia induction and maintenance and a prolonged recovery time compared with controls. © 2010 The Acta Anaesthesiologica Scandinavica Foundation.en_HK
dc.languageengen_US
dc.publisherBlackwell Publishing, Inc. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AASen_HK
dc.relation.ispartofActa Anaesthesiologica Scandinavicaen_HK
dc.rightsThe definitive version is available at www.blackwell-synergy.comen_US
dc.subject.meshAnesthetics - administration and dosage - adverse effectsen_US
dc.subject.meshHemodynamics - drug effectsen_US
dc.subject.meshIsoflurane - administration and dosage - adverse effectsen_US
dc.subject.meshJaundice, Obstructive - complications - physiopathologyen_US
dc.subject.meshProspective Studiesen_US
dc.titleA clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundiceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0001-5172&volume=54&issue=7&spage=871&epage=877&date=2010&atitle=A+clinical+prospective+comparison+of+anesthetics+sensitivity+and+hemodynamic+effect+among+patients+with+or+without+obstructive+jaundiceen_US
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_HK
dc.identifier.authorityIrwin, MG=rp00390en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1399-6576.2010.02222.xen_HK
dc.identifier.pmid20236100-
dc.identifier.scopuseid_2-s2.0-77954362179en_HK
dc.identifier.hkuros184515en_US
dc.identifier.hkuros177959en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77954362179&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume54en_HK
dc.identifier.issue7en_HK
dc.identifier.spage871en_HK
dc.identifier.epage877en_HK
dc.identifier.isiWOS:000279534100013-
dc.publisher.placeDenmarken_HK
dc.identifier.citeulike7473142-

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