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Article: Total intravenous anaesthesia with propofol and remifentanil for elective neurosurgical procedures: An audit of early postoperative complications

TitleTotal intravenous anaesthesia with propofol and remifentanil for elective neurosurgical procedures: An audit of early postoperative complications
Authors
KeywordsAnaesthesia intravenous
Analgesics opioid, remifentanil
Intravenous anaesthetics, propofol
Neurosurgical procedures, craniotomy, supratentorial, posterior fossa, extracranial, intracranial vascular, transphenoidal hypophysectomy
Issue Date2006
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=EJA
Citation
European Journal Of Anaesthesiology, 2006, v. 23 n. 7, p. 586-590 How to Cite?
AbstractBackground and objectives: This was a prospective audit to assess the incidence and characteristics of early postoperative complications in the recovery room in extubated patients after elective neurosurgical procedures using propofol and remifentanil-based total intravenous anaesthesia. Methods: Vital signs (temperature, conscious level, respiratory rate, oxygen saturation, pulse and blood pressure) and postoperative complications (shivering, nausea, vomiting and cardiorespiratory) were analysed in 145 adult patients over a 1-yr period. Results: The overall shivering, postoperative nausea and vomiting and postoperative hypertension (systolic blood pressure more than 25% of the preoperative value) incidences were 30.3%, 16.6% and 35.2%, respectively. Fifty-one percent of the patients had at least one of the above complications. The complication rates were found to be widely different among various types of neurosurgery. The surgical procedures were divided into five groups: supratentorial craniotomy, posterior fossa craniotomy, intracranial vascular procedures, transphenoidal hypophysectomy and extracranial procedures. Median extubation time was similar in all groups and patients were fully conscious with no hypoxia in the recovery room. The intracranial vascular group had the highest shivering and postoperative nausea and vomiting rates (58.8% and 29.4%, respectively). In the supratentorial craniotomy group, 46% of the patients had hypertension. The overall complication rate (presence of any complications) was highest in the supratentfial craniotomy (55.4%), posterior fossa craniotomy (75%) and intracranial vascular (76.5%) groups. Shivering and overall complication rate was significantly related to the anaesthetic time (P ≤ 0.001 and 0.02, respectively). Conclusions: Despite the potential advantages of total intravenous anaesthesia in titratability, rapid return of consciousness and reduced respiratory complications, making it suitable for planned extubation at the end of neurosurgery, the postoperative complications of shivering, postoperative nausea and vomiting and hypertension were still high. © 2006 Copyright European Society of Anaesthesiology.
Persistent Identifierhttp://hdl.handle.net/10722/44556
ISSN
2015 Impact Factor: 3.634
2015 SCImago Journal Rankings: 0.999
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, AYCen_HK
dc.contributor.authorO'Regan, AMen_HK
dc.contributor.authorIrwin, MGen_HK
dc.date.accessioned2007-10-30T06:04:10Z-
dc.date.available2007-10-30T06:04:10Z-
dc.date.issued2006en_HK
dc.identifier.citationEuropean Journal Of Anaesthesiology, 2006, v. 23 n. 7, p. 586-590en_HK
dc.identifier.issn0265-0215en_HK
dc.identifier.urihttp://hdl.handle.net/10722/44556-
dc.description.abstractBackground and objectives: This was a prospective audit to assess the incidence and characteristics of early postoperative complications in the recovery room in extubated patients after elective neurosurgical procedures using propofol and remifentanil-based total intravenous anaesthesia. Methods: Vital signs (temperature, conscious level, respiratory rate, oxygen saturation, pulse and blood pressure) and postoperative complications (shivering, nausea, vomiting and cardiorespiratory) were analysed in 145 adult patients over a 1-yr period. Results: The overall shivering, postoperative nausea and vomiting and postoperative hypertension (systolic blood pressure more than 25% of the preoperative value) incidences were 30.3%, 16.6% and 35.2%, respectively. Fifty-one percent of the patients had at least one of the above complications. The complication rates were found to be widely different among various types of neurosurgery. The surgical procedures were divided into five groups: supratentorial craniotomy, posterior fossa craniotomy, intracranial vascular procedures, transphenoidal hypophysectomy and extracranial procedures. Median extubation time was similar in all groups and patients were fully conscious with no hypoxia in the recovery room. The intracranial vascular group had the highest shivering and postoperative nausea and vomiting rates (58.8% and 29.4%, respectively). In the supratentorial craniotomy group, 46% of the patients had hypertension. The overall complication rate (presence of any complications) was highest in the supratentfial craniotomy (55.4%), posterior fossa craniotomy (75%) and intracranial vascular (76.5%) groups. Shivering and overall complication rate was significantly related to the anaesthetic time (P ≤ 0.001 and 0.02, respectively). Conclusions: Despite the potential advantages of total intravenous anaesthesia in titratability, rapid return of consciousness and reduced respiratory complications, making it suitable for planned extubation at the end of neurosurgery, the postoperative complications of shivering, postoperative nausea and vomiting and hypertension were still high. © 2006 Copyright European Society of Anaesthesiology.en_HK
dc.format.extent75126 bytes-
dc.format.extent1101122 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=EJAen_HK
dc.relation.ispartofEuropean Journal of Anaesthesiologyen_HK
dc.rightsEuropean Journal of Anaesthesiology. Copyright © Cambridge University Press.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAnaesthesia intravenousen_HK
dc.subjectAnalgesics opioid, remifentanilen_HK
dc.subjectIntravenous anaesthetics, propofolen_HK
dc.subjectNeurosurgical procedures, craniotomy, supratentorial, posterior fossa, extracranial, intracranial vascular, transphenoidal hypophysectomyen_HK
dc.subject.meshAnesthesia,-Intravenousen_HK
dc.subject.meshMedical-Auditen_HK
dc.subject.meshNeurosurgical-Proceduresen_HK
dc.subject.meshPiperidines-pharmacologyen_HK
dc.subject.meshPostoperative-Complications-chemically-induceden_HK
dc.titleTotal intravenous anaesthesia with propofol and remifentanil for elective neurosurgical procedures: An audit of early postoperative complicationsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0265-0215&volume=23&issue=7&spage=586&epage=590&date=2006&atitle=Total+intravenous+anaesthesia+with+propofol+and+remifentanil+for+elective+neurosurgical+procedures:+an+audit+of+early+postoperative+complicationsen_HK
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_HK
dc.identifier.authorityIrwin, MG=rp00390en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1017/S0265021506000214en_HK
dc.identifier.pmid16507198-
dc.identifier.scopuseid_2-s2.0-33646504114en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646504114&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume23en_HK
dc.identifier.issue7en_HK
dc.identifier.spage586en_HK
dc.identifier.epage590en_HK
dc.identifier.isiWOS:000238752100008-
dc.publisher.placeUnited Kingdomen_HK

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