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Comparison Between Remifentanil And Fentanyl Effects on
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A.R Purnajafian *   1, S Ghavam , S Ghavam , M.R Hafezi Ahmadi , M Ghavam |
| 1- , drpournajafian@iums.ac.ir |
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Abstract: (33136 Views) |
| Introduction: Intravenous opioid injection
as premedication is one of the most
common methods for preventing and
controlling hemodynamic changes due to
laryngoscopy and tracheal intubation. Using
such drugs is not suggestsd in pregnant
women who candidate for cesarean section,
because of respiratory depression in the
newborn, but in special conditions such as
preeclampsia, anesthetists can inject low
doses of fentanyl(as a synthetic opioid).
Because of rapid metabolism of
remifentanil and no respiratory effects in
the newborn, it can be introduced as a
perfect alternative for longer acting opioids
in such conditions.
Materials & Methods: This study was
done as a randomized clinical trial on
preeclamptic pregnant women who were
candidate for cesarean section under
general anesthesia. They were divided into
two groups: in one group 1ml. fentanyl was
injected before induction of
anesthesia(n1=18) , and in the other group
0.05 g/kg/min remifentanil was infused for
3 minutes before induction (n2=20).
Afterwars, of heart rate, systolic and
diastolic blood pressures before and after
intubation and also the newborn's apgar
were measured and assessed.
Findings: All hemodynamic indices
increased after intubation in the fentanyl
group , and increase in diastolic pressure an
heart rate was significant. Mild increase in
heart rate and decreasing in systolic and
diastolic blood pressure after intubation in
remifentanil group was achieved that the
decrease in systolic blood pressure was
significantly different(R1=154.35,
R2=148.35). Comparison of changes
between the two groups also demonstrated
significant difference (Pval.<0.05). The
newborns mean apgar score showed no
signifant difference between the two
groups(AP.remi=0.88, AP.fent=0.86).
Discussion and Conclusion: Considering
no difference between the newborns apgar
in both the groups and results of assessment
of hemodynamic indices, it can be
suggested to use remifentanyl in pregnant
women who are candidate for cesarean
section under general anesthesia to prevent
severe increase in blood pressure and heart
rate during tracheal intubation. |
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| Keywords: cesarean section, preeclampsy |
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Full-Text [PDF 155 kb]
(3951 Downloads)
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Type of Study: Research |
Subject:
General
Received: 2012/03/13 | Published: 2012/01/15
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