Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942013000300005
Brazilian Journal of Anesthesiology
Scientific Article

Efeito da administração de solução salina na estabilidade da circulação durante a indução de anestesia geral com propofol em estudo randômico e controlado de procedimentos ginecológicos

Effect of normal saline administration on circulation stability during general anesthesia induction with propofol in gynecological procedures - randomised-controlled study

Daher Rabadi

http://dx.doi.org/10.1590/S0034-70942013000300005 Braz J Anesthesiol, vol.63, n3, p.258-261, 2013
PDF Português
PDF English
Downloads: 0
Views: 947

Resumo

JUSTIFICATIVA E OBJETIVO: Comparar o efeito da administração profilática de solução salina normal com o efeito hipotensor de propofol em pacientes do sexo feminino programadas para procedimentos ginecológicos. MÉTODO: Foram randomicamente alocadas em dois grupos 69 pacientes, ASA I-II. O Grupo 1 recebeu 5 mL.kg-1 de solução salina a 0,9% 10 minutos antes da indução e o Grupo 2 não recebeu nada (controle). A anestesia foi induzida com propofol e fentanil e depois mantida com propofol e remifentanil. As variáveis hemodinâmicas foram mensuradas pré- e pós-indução da anestesia geral. RESULTADOS: Após a indução, ambos os grupos apresentaram queda significativa da pressão arterial média (p < 0,001) e redução também significativa da frequência cardíaca (p < 0,02 no grupo de estudo e p < 0,001 no grupo de controle). A pressão arterial média pré-indução teve uma queda de mais de 25% em 35% dos pacientes do grupo controle em comparação com apenas 17% dos pacientes que receberam a solução salina (p < 0,04). CONCLUSÃO: A administração profilática de solução salina pode diminuir a porcentagem de pacientes que apresentam queda significativa da pressão arterial após a indução de propofol em anestesia geral.

Palavras-chave

INDUÇÃO ANESTÉSICA, Venosa, HIDRATAÇÃO, Soluções Isotônicas, ANESTESIA, Geral, ANESTÉSICOS, Venoso, propofol, SISTEMA CIRCULATÓRIO

Abstract

BACKGROUND AND OBJECTIVE: To compare the effect of prophylactic administration of normal saline against the hypotensive effect of propofol in female patients booked for gynecological procedures. METHOD: Sixty nine ASA (I, II) patients were randomly allocated into two groups, group 1 received 5 mL.kg-1 of 0.9% normal saline 10 minutes before induction, whereas group 2 received nothing (control). Anesthesia was induced with propofol and fentanyl then maintained with propofol and remifentanil. We measured hemodynamic variables pre and post general anesthesia induction. RESULTS: Both groups had significant drops in post induction mean arterial blood pressure (P < 0.001). Also both groups had significant drops in post induction heart rate ((P < 0.02 in sample group and P < 0.001 in control group), and 35% of patients in the control group had more than 25% drop in the pre induction mean arterial blood pressure, compared with only 17% of patients in the saline group (P < 0.04). CONCLUSION: The prophylactic administration of normal saline could decrease the percentage of patients who had a significant drop in their blood pressure after propofol induction of general anesthesia.

Keywords

Isotonic Solutions, Anesthesia, Propofol, Blood Pressure, Heart Rate

References

Michelsen I, Helbo-Hansen HS, Køhler F, Lorenzen AG, Rydlund E, Bentzon MW. Prophylactic ephedrine attenuates the hemodynamic response to propofol in elderly female patients. Anesth Analg. 1998;86:477-481.

Gamlin F, Vucevic M, Winslow L, Berridge J. The haemodynamic effects of propofol in combination with ephedrine. Anaesthesia. 1996;51:488-491.

Gamlin F, Freeman J, Winslow L, Berridge J, Vucevic M. The haemodynamic effects of propofol in combination with ephedrine in elderly patients (ASA groups 3 and 4). Anaesth Intensive Care. 1999;27:477-480.

Turner RJ, Gatt SP, Kam PC, Ramzan I, Daley M. Administration of a crystalloid fluid preload does not prevent the decrease in arterial blood pressure after induction of anaesthesia with propofol and fentanyl. Br J Anaesth. 1998;80:737-741.

Fairfield JE, Dritsas A, Beale RJ. Haemodynamic effects of propofol: induction with 2.5 mg kg-1. Br J Anaesth. 1991;67:618-620.

Marik PE. Propofol: therapeutic indications and side-effects. Curr Pharm Des. 2004;10:3639-649.

Searle NR, Sahab P. Propofol in patients with cardiac disease. Can J Anaesth. 1993;40:730-747.

Vuyk J, Engbers FHM, Lemmens HJM. Pharmacodynamics of propofol in female patients. Anesthesiology. 1992;77:3-779.

Smith C, McEwan E, Jhaveri R. The interaction of fentanyl on the Cl'50 of propofol for loss of consciousness. Anesthesiology. 1994;81:820-828.

Lindholm P, Helbo-Hansen HS, Jensen B, Bülow K, Nielsen TG. Effects of fentany1 or alfentanil as supplement to propofol anaesthesia for termination of pregnancy. Acta Anaesthesiol Stand. 1994;38:545-549.

Stephan H, Sonntag H, Schenk HD. Effects of propofol on cardiovascular dynamics, myocardial blood flow, and myocardial metabolism in patients with coronary artery disease. Br J Anaesth. 1986;58:969-975.

Vermeyen KM, De Hert SG, Erpels FA, Adriaensen HF. Myocardial metabolism during anaesthesia with propofol: low dose fentanyl for coronary artery bypass surgery. Br J Anaesth. 1991;66:504-S.

Warden JC, Pickford DR. Fatal cardiovascular collapse following propofol induction in high-risk patients and dilemmas in the selection of a short-acting induction agent. Anaesth Intensive Care. 1995;23:485-487.

5dd422da0e8825350dc63494 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections