Effects of remifentanil-based general anaesthesia with propofol or sevoflurane on muscle microcirculation as assessed by near-infrared spectroscopy
| Autor: | Stefano Palmisani, R. Arcioni, F. Troisi, S. Collini, R. A. De Blasi, G. Pinto, M. Boezi |
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| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Methyl Ethers Adolescent anaesthetics volatile anaesthesia general anaesthetics volatile sevoflurane microcirculation propofol Anesthetics General Oral Surgical Procedures Remifentanil sevoflurane microcirculation Blood volume Sevoflurane Microcirculation Oxygen Consumption Piperidines Monitoring Intraoperative medicine Humans General anaesthesia Prospective Studies Muscle Skeletal Aged Spectroscopy Near-Infrared propofol business.industry Blood flow Middle Aged Anesthetics Combined Anesthesiology and Pain Medicine medicine.anatomical_structure general Anesthesia Anesthetics Inhalation Vascular resistance Female Propofol business Anesthetics Intravenous medicine.drug |
| Popis: | Although anaesthetics are known to alter microcirculation no study has, to our knowledge, documented changes in human skeletal microcirculatory function during general anaesthesia.Forty-four patients undergoing maxillofacial surgery at a university hospital were prospectively randomized to receive general anaesthesia with remifentanil combined with propofol or sevoflurane. Muscle microcirculation was investigated with near-infrared spectroscopy (NIRS) before general anaesthesia was induced and 30 min later. An NIRS device (NIMO, Nirox) was used to quantify calf deoxyhaemoglobin [HHb], oxyhaemoglobin [HbO2], and total haemoglobin [HbT] concentrations, coupled to a series of venous and arterial occlusions to measure calf blood flow, muscle oxygen consumption, calf vascular resistance, microvascular compliance, and haemoglobin resaturation rate (RR).In both the groups, general anaesthesia induced marked changes in muscle microcirculation: the tissue blood volume increased (+33% in remifentanil-sevoflurane and +45% with remifentanil-propofol groups), microvascular resistance decreased (-31% and -38%, respectively), and the post-ischaemic haemoglobin RR decreased (-48% and -36%, respectively). In the remifentanil-propofol group, the muscle blood flow increased (P0.001), whereas in the remifentanil-sevoflurane group microvascular compliance and muscle oxygen consumption decreased (P0.01).Remifentanil-based general anaesthesia with propofol or sevoflurane altered the muscle microcirculation in different ways. Quantitative NIRS, a technique that takes into account the optical tissue properties of the individual subject, can effectively measure these changes non-invasively. |
| Databáze: | OpenAIRE |
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