title: Effects of target-controlled anesthesia with propofol and sufentanil on the hemodynamic response to Mayfield head holder application.
abstract: The effects of target-controlled anesthesia with propofol and sufentanil on the hemodynamic response to Mayfield head holder (MH) application were evaluated in 18 ASA I and II patients undergoing scheduled intracranial surgery. Premedication consisted of hydroxyzine, alprazolam and atropine given orally 1 h before surgery. Anesthesia was provided with propofol and sufentanil using a target-controlled infusion device; constant calculated plasma concentrations of 4 micrograms ml-1 propofol and 0.5 ng ml-1 sufentanil were maintained throughout the study. Muscle relaxation was obtained with atracurium and ventilation was controlled with air/oxygen. The MH was fixed 45 +/- 12 min (mean +/- SD) after induction of anesthesia. Heart rate and systolic, diastolic, and mean non invasive arterial pressure were monitored and recorded 5 min before induction of anesthesia (control), 1 min before MH application (MH-1), at MH application, and 1 and 2 min after MH application. Systolic, diastolic, mean arterial pressure, and heart rate increased significantly during and after MH application when compared with MH-1 values, but remained constantly lower than control. Hemodynamic parameters measured 1 min before MH application were significantly lower than control. The results of the study indicate that target-controlled anesthesia maintained with constant calculated plasma concentrations of 4 micrograms ml-1 propofol and 0.5 ng ml-1 sufentanil prevents the increase in arterial pressure and heart rate beyond control values following MH application but may induce some degree of arterial hypotension in the absence of nociceptive stimulation.
authors.affiliation: Department of Anesthesia & Intensive Care Medicine, University Hospital of Liège, Domaine Universitaire du Sart Tilman, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Hans
authors.forename: E
authors.initials: E
authors.lastname: Coussaert
authors.forename: F
authors.initials: F
authors.lastname: Cantraine
authors.forename: P Y
authors.initials: PY
authors.lastname: Dewandre
authors.forename: J F
authors.initials: JF
authors.lastname: Brichant
authors.forename: M
authors.initials: M
authors.lastname: Grevesse
authors.forename: M
authors.initials: M
authors.lastname: Lamy
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000525:Alprazolam / Q000627:therapeutic use; D000704:Analysis of Variance; D000771:Anesthesia, Intravenous / Q000295:instrumentation / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000097:blood; D001279:Atracurium / Q000008:administration & dosage; D001285:Atropine / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D001921:Brain / Q000601:surgery; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006919:Hydroxyzine / Q000627:therapeutic use; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007022:Hypotension / Q000139:chemically induced; D007260:Infusion Pumps; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D009493:Neurosurgery / Q000295:instrumentation*; D010146:Pain / Q000503:physiopathology; D011229:Preanesthetic Medication; D015742:Propofol / Q000008:administration & dosage* / Q000097:blood; D017409:Sufentanil / Q000008:administration & dosage* / Q000097:blood
chemical_list: D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D006919:Hydroxyzine; D001285:Atropine; D017409:Sufentanil; D015742:Propofol; D000525:Alprazolam