Optimal Target Concentration of Alfentanil for the Sedation of Urologic Surgical Patients. |
Dong Hee Kim, Ji Wook Kim |
Department of Anesthesiology, College of Medicine, Dankook University, Cheonan, Korea. anedhkim@hanmail.net |
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Abstract |
BACKGROUND The purpose of this study was to define the optimal target concentration of alfentanil effective in achieving a sedative, antianxiety and analgesic effect during spinal anesthesia in urologic patients. METHODS Sixty patients underwent spinal anesthesia with 0.5% hyperbaric bupivacaine 12-18 mg and received a target controlled infusion (TCI) of alfentanil with 0 ng/ml (group A0, n = 15), 20 ng/ml (group A20, n = 15), 30 ng/ml (group A30, n = 15) or 40 ng/ml (group A40, n = 15). Sedation scale, bispectral index (BIS), anxiety level and infusion rate of alfentanil were checked during the operation. RESULTS Sedation scale was significantly higher in group A30 (3.3) and A40 (3.8) than group A0 (1.9) and A20 (2.5)(P<0.05). Incidences of intraoperative hypotension, respiratory depression, postoperative nausea and vomiting, and dizziness were significantly higher in group A40 than the other groups (P<0.05). There were no significant differences in BIS, anxiety level and incidences of recall of the operative procedure among the groups (P<0.05). CONCLUSIONS TCI of alfentanil with 30 ng/ml produces effective sedation and antianxiety effect without significant side effects during spinal anesthesia. |
Key Words:
Alfentanil; sedation; spinal anesthesia; target-controlled infusion (TCI) |
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