title: Adding remifentanil to propofol and etomidate in cardioversion anesthesia.
abstract: OBJECTIVE
  To compare their effects on cardiorespiratoy and recovery parameters and side effects.
  
  
  METHODS
  This study was performed in The Ministry of Health Ankara Numune Research and Training Hospital, Ankara, Turkey, from January to May 2005. The 40 American Society of Anesthesiology II/III patients were randomized into 2 groups. All patients received remifentanil 0.75 microgram.kg(-1); and then received either etomidate 0.1 mg.kg(-1) (group E, n=20) or propofol 0.5 mg.kg(-1) (group P, n=20). Cardiorespiratory data, induction time, recovery parameters, pain scores, number of shocks (NS), total amount of energy used (TE), side effects, and patient/cardiologist satisfaction were recorded.
  
  
  RESULTS
  Induction time and recovery parameters were shorter in group P. No differences were seen between the groups in NS and mean TE required. In group P, a statistically significant decrease in mean blood pressure occurred after induction and returned to its baseline levels in 6 minutes. After cardioversion over 2 minutes, the respiratory rates were decreased significantly more in group P when compared with group E. Two patients in group P became apneic and needed assisted ventilation. Pain scores, side effects and patient/cardiologist satisfaction were similar in both groups. No patients in either group had myoclonus.
  
  
  CONCLUSIONS
  We can induce hypnosis with propofol 0.5 mg.kg(-1) or etomidate 0.1 mg.kg(-1) by adding remifentanil 0.75 microgram.kg-1 in cardioversion anesthesia. Although recovery parameters were longer in group E, and cardiorespiratory parameters were less stable in group P, their usage with remifentanil was both acceptable for cardioversion anesthesia.
authors.affiliation: Department of Anesthesiology, The Ministry of Health Ankara Numune Research and Training Hospital, Ankara Numune Hastanesi, Ankara, Turkey. zakcaboy@yahoo.com
authors.forename: Zeynep N
authors.initials: ZN
authors.lastname: Akcaboy
authors.forename: Erkan Y
authors.initials: EY
authors.lastname: Akcaboy
authors.forename: Berrin
authors.initials: B
authors.lastname: Altinoren
authors.forename: Erdem
authors.initials: E
authors.lastname: Karabulut
authors.forename: Nermin
authors.initials: N
authors.lastname: Gogus
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001145:Arrhythmias, Cardiac / Q000628:therapy; D004554:Electric Countershock; D005045:Etomidate / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol; D005045:Etomidate