Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
[Remifentanil and alfentanil: Sympathetic-adrenergic effect in the first postoperative phase in patients at cardiovascular risk].
Extubation and the immediate postoperative period are critical periods with strong sympatho-adrenergic stimulation. The aim of the present study was to investigate this period after balanced anaesthesia with remifentanil and alfentanil in cardiac risk patients. ⋯ After balanced anaesthesia with remifentanil a more pronounced sympatho-adrenergic stimulation occurs because of the more rapid clearance of the analgesic effect in the recovery period compared to alfentanil requiring more analgesics and medications for the control of the haemodynamic parameters. Because of these specific pharmacological effects the use of remifentanil in cardiac risk patients has to be critically discussed.
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The unwanted side effects of muscle relaxants used for anaesthesia in the newborn and infants resulted in a search for alternatives to atraumatic intubation (IN). The study was aimed to investigate conditions of intubation, time of intubation as well as changes in systolic, mean and diastolic blood pressure (RRs/RRm/RRd) and heart rate (HR) under the use of propofol (P) after narcosis induction by mask. ⋯ In the observation period, changes in heart rate stayed in the range of reference. In our opinion the excellent and good conditions for intubation, as well as the ultrashort drug-onset and intubation time demonstrate the good characteristics afforded by propofol to perform intubation in infancy.