Evaluatie van de effecten van de toevoeging van atropine tijdens propofol/remifentanil inductie van anesthesie op de hemodynamiek, microvasculaire doorbloeding en weefseloxygenatie bij patiënten die oogheelkundige chirurgie ondergaan.

Velde, M. I. van der (2013) Evaluatie van de effecten van de toevoeging van atropine tijdens propofol/remifentanil inductie van anesthesie op de hemodynamiek, microvasculaire doorbloeding en weefseloxygenatie bij patiënten die oogheelkundige chirurgie ondergaan. thesis, Medicine.

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Abstract

Induction of anaesthesia with propofol and remifentanil in ophthalmic surgery often induces unwanted bradycardia and hypotension. This raises the concern for preserving haemodynamic stability and adequate tissue oxygenation. The aim of this study is to investigate if prophylactic administration of atropine at induction of anaesthesia can attenuate these negative haemodynamic effects and thus maintain tissue oxygenation. 53 patients were included in this double blind, randomised controlled trial. MAP, heart rate and cardiac output were continuously recorded with the Nexfin device. The FORE-SIGHT® and InSpectra™ oximeters monitored cerebral and peripheral tissue oxygenation, respectively. Euvolemia was pursued by infusion of 500ml colloid solution prior to anaesthesia, which was induced with remifentanil TCI, propofol TCI, and cis-atracurium. According to randomisation methylatropine (500μg, 1ml) or saline (1ml) was administered at start of induction of anaesthesia. We studied the evolution of the variables from induction of anesthesia until 10 minutes thereafter of 27 saline and 26 atropine patients, respectively. Atropine prophylaxis resulted in better haemodynamics with a significantly higher MAP, heart rate and cardiac output compared to the saline group. There was no intergroup difference in tissue oxygenation. Therefore, prophylactic administration of atropine at induction of remifentanil/propofol anaesthesia is an effective approach to anticipate its negative haemodynamic effects.

Item Type:	Thesis (Thesis)
Supervisor name:	Kalmar, Dr. A. F.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1701

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