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• W2514290615 abstract "Background & Objectives: Remifentanil is an ultra short acting opioid which can be delivered using target-controlled infusion (TCI) mode. The aims of the study were to compare the effects of two target-effect concentration (Cet) of remifentanil, 3 ng/ml and 5 ng/ml, in obtunding haemodynamic and neuroendocrinal response after skull pin head holder application for elective supratentorial craniotomy. Materials & Methods: 88 patients, aged between 18–60 year old with ASA I and II, were randomized into two groups; Group I: Cet 3 ng/ml (n=44) and Group II: Cet 5 ng/ml (n=44). All patients were earlier induced with Cet remifentanil of 2 ng/ml, target plasma concentration (Cpt) propofol of 4–6 mcg/ml using Marsh model and then paralyzed with rocuronium 0.6 mg/kg for intubation. Anaesthesia was maintained with Cpt propofol between 3–6 mcg/ml and Cet remifentanil of 2 ng/ml. Before the skull pin head holder application, Cet remifentanil was increased to either 3 ng/ml or 5 ng/ml depending on the randomization. Haemodynamic parameters were measured at baseline, 1 min, 5 min and 10 min after pinning. Serum cortisol and glucose were measured before and 30 min after pinning. Subsequent anaesthetic management was continued according to the requirement of the surgery using total intravenous anaesthesia (TIVA)/TCI technique. Results: Cet remifentanil 5 ng/ml group had significant reduction in the means of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) if compared to Cet remifentanil 3 ng/ml group at baseline,1 min,5 min and 10 min after pinning (p<0.001). Mean serum cortisol 30 minutes after pinning was significantly lower in Cet remifentanil 5 ng/ml group than Cet remifentanil 3 ng/ml group [330.48(103.86) vs 392.23(104.30) nmol/l; p=0.007]. Mean serum glucose 30 minutes after pinning was also significantly lower in Cet remifentanil 5 ng/ml group than Cet remifentanil 3 ng/ml group [7.63(1.01) vs 8.46(1.20) mmol/l; p=0.001]. There were no significant differences in mean serum cortisol and serum glucose before pinning between the two groups. Conclusion: Cet remifentanil 5 ng/ml was more effective than Cet remifentanil 3 ng/ml in obtunding the haemodynamics and neuroendocrinal response during skull pin head holder application. Disclosure of Interest: W. M. N. W Hassan Research grant/funding from: None, Employee of: None, Shareholder of: None, Personal interest: None, Conflict with: None, S. Chandran Research grant/funding from: None, Employee of: None, Shareholder of: None, Personal interest: None, Conflict with: None, R. H. Mohd Zaini Research grant/funding from: None, Employee of: None, Shareholder of: None, Personal interest: None, Conflict with: None, M. H. Hassan Research grant/funding from: None, Employee of: None, Shareholder of: None, Personal interest: None, Conflict with: none" @default.
• W2514290615 created "2016-09-16" @default.
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• W2514290615 date "2016-09-01" @default.
• W2514290615 modified "2023-09-26" @default.
• W2514290615 title "Abstract PR173" @default.
• W2514290615 doi "https://doi.org/10.1213/01.ane.0000496975.84851.51" @default.
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