Maternal and foetal effects of remifentanil for general anaesthesia in parturients undergoing caesarean section: a systematic review and meta-analysis.

Abstract:

BACKGROUND:Remifentanil has been suggested for the induction of general anaesthesia for caesarean section. We aimed to define remifentanil effects on maternal stress response as well as neonatal effects. METHODS:Relevant articles were retrieved by a systematic literature search. Randomized, controlled trials comparing remifentanil use before delivery with placebo were selected. Maternal outcome parameters were blood pressure and heart rate; neonatal effects included the need for mask ventilation and intubation, base excess, pH values, Apgar < 7 at 1 and 5 min. The random effects model was used for meta-analysis; risk ratio or weighted mean difference (WMD) and 95% confidence interval (95% CI) were calculated. RESULTS:Five articles including 186 patients were identified. Highest and lowest systolic blood pressure were significantly lower in the remifentanil group (WMD: -29.98, -50.90 to -9.07 mmHg, 95% CI; P = 0.005; and WMD: -12.46, -18.21 to -6.71 mmHg, 95% CI; P < 0.0001), the lowest heart rate was significantly lower after remifentanil treatment (WMD: -8.22, -11.67 to -4.78, 95% CI; P < 0.00001). Base excess was significantly higher in infants of remifentanil-treated mothers (WMD: 1.15, -0.27 to 2.03, 95% CI; P = 0.01); pH was also higher in the remifentanil group, but significance was missed (P = 0.07). No differences were observed for Apgar values or the need of airway assist. CONCLUSION:Remifentanil was found to attenuate the maternal circulatory response to intubation and surgery. Higher base excess and pH suggest a beneficial effect on the neonatal acid-base status. A trial with adequate power is warranted that addresses neonatal side-effects of remifentanil.

authors

Heesen M,Klöhr S,Hofmann T,Rossaint R,Devroe S,Straube S,Van de Velde M

doi

10.1111/j.1399-6576.2012.02723.x

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

29-36

issue

1

eissn

0001-5172

issn

1399-6576

journal_volume

57

pub_type

杂志文章,meta分析,评审
  • Electrophysiological effects of desflurane in children with Wolff-Parkinson-White syndrome: a randomized crossover study.

    abstract:BACKGROUND:We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. METHODS:In this randomized crossover study, children aged 4.1-16.1 years und...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/aas.13023

    authors: Hino H,Oda Y,Yoshida Y,Suzuki T,Shimada M,Nishikawa K

    更新日期:2018-02-01 00:00:00

  • Amelioration of respiratory and circulatory changes in established endotoxic shock by ketoprofen.

    abstract::In an intensive-care setting we studied the effects of ketoprofen, a dual inhibitor of cyclooxygenase and lipoxygenase, on circulatory and respiratory changes during established endotoxic shock in sheep. Two groups (n = 7 in each) were exposed to E. coli endotoxin, which caused a sharp increase in pulmonary artery pre...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1994.tb03833.x

    authors: Sigurdsson GH,Youssef H

    更新日期:1994-01-01 00:00:00

  • Addition of lidocaine to bupivacaine for spinal anaesthesia compared with bupivacaine spinal anaesthesia and local infiltration anaesthesia.

    abstract:BACKGROUND:Two spinal anaesthesia techniques were compared with local infiltration anaesthesia (LIA) to test the hypothesis that the addition of lidocaine to bupivacaine would decrease the spinal block's duration and provide shorter recovery to discharge. METHODS:Ninety-three patients undergoing outpatient herniorrhap...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/aas.12175

    authors: Yazicioglu D,Akkaya T,Kulacoglu H

    更新日期:2013-11-01 00:00:00

  • Oxygen analyzers in anaesthesia: performance in a simulated clinical environment.

    abstract::Nine commercial oxygen analyzers were tested in a laboratory model stimulating clinical anaesthesia conditions. Fifteen test situations were used in order to study the effects of nitrous oxide, humidity, positive end-expiratory pressure, halothane, enflurane and isoflurane. Errors exceeding 8 vol% were not uncommon, t...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1986.tb02495.x

    authors: Bengtson JP,Sonander H,Stenqvist O

    更新日期:1986-11-01 00:00:00

  • The pressor response after laryngeal mask or cuffed oropharyngeal airway insertion.

    abstract:BACKGROUND:Since the cuffed oropharyngeal airway (COPA) has been suggested to cause less pharyngeal trauma than the laryngeal mask airway (LMA), we conducted a prospective, randomised study to compare haemodynamic changes after placing either the COPA or LMA in healthy anaesthetised adults. METHODS:After standard mida...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1034/j.1399-6576.1999.431014.x

    authors: Casati A,Cappelleri G,Fanelli G,Magistris L,Beccaria P,Albertin A,Torri G

    更新日期:1999-11-01 00:00:00

  • Perioperative use of modified thrombelastography in factor XI deficiency: a helpful method to assess drug effects.

    abstract::Factor XI deficiency is a rare, hereditary bleeding disorder associated with a trauma-related bleeding tendency, caused by insufficient generation of the thrombin activatable fibrinolysis inhibitor (TAFI) evoking increased fibrinolysis. We present the case of a five year old girl with homozygote, severe factor XI defi...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2007.01284.x

    authors: Dirkmann D,Hanke AA,Görlinger K,Peters J

    更新日期:2007-05-01 00:00:00

  • Neostigmine 50 microg kg(-1) with glycopyrrolate increases postoperative nausea in women after laparoscopic gynaecological surgery.

    abstract:BACKGROUND:Neostigmine, used for reversal of neuromuscular block, has been implicated in the development of postoperative nausea and vomiting (PONV). The use of mivacurium, which does not require neostigmine reversal due to its metabolism by plasma cholinesterase, has made it possible to study the effect of neostigmine...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1034/j.1399-6576.2001.045004495.x

    authors: Løvstad RZ,Thagaard KS,Berner NS,Raeder JC

    更新日期:2001-04-01 00:00:00

  • Propofol sedation and gastric emptying in volunteers.

    abstract:BACKGROUND:The purpose of this study was to evaluate the effects of light propofol sedation on gastric emptying and orocecal transit time (OCT). METHODS:Ten healthy male volunteers were studied on 2 occasions separated by at least 1 week and were randomly allocated to receive either propofol sedation or i.v. saline as...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.1998.tb05088.x

    authors: Hammas B,Hvarfner A,Thörn SE,Wattwil M

    更新日期:1998-01-01 00:00:00

  • Comparative potency and speed of onset of fazadinium and d-tubocurarine.

    abstract::The potency and speed of onset of fazadinium and d-tubocurarine have been compared at three cumulative doses. Wtih thiopentone as the induction agent, the dose ratio fazadinium/d-tubocurarine ranged from 1.2 to 1.3 for single twitch reduction and from 1.1 to 1.2 for reduction of tetanus. The times taken for the develo...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1979.tb01459.x

    authors: Hussain SZ,Healy TE,Birmingham AT

    更新日期:1979-08-01 00:00:00

  • Comparison of the effect of ketamine added to bupivacaine and ropivacaine, on stress hormone levels and the duration of caudal analgesia.

    abstract:BACKGROUND:The aim of this study was to compare bupivacaine 0.25% and ropivacaine 0.2%, singly and in combination with ketamine, for caudal administration in children. Duration of analgesia, the need for other analgesics and the stress response were measured. METHODS:Eighty children were randomized into four groups of...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.2005.00806.x

    authors: Akbas M,Titiz TA,Ertugrul F,Akbas H,Melikoglu M

    更新日期:2005-11-01 00:00:00

  • CT-proAVP (copeptin), MR-proANP and Peroxiredoxin 4 after cardiac arrest: release profiles and correlation to outcome.

    abstract:BACKGROUND:Further characterization of the post-cardiac arrest syndrome (PCAS) is essential to better understand the mechanisms resulting in injury and death. We investigated serial serum concentrations of the stress hormone c-terminal provasopressin (CT-proAVP or copeptin), the cardiac biomarker MR-proANP and a biomar...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.12282

    authors: Annborn M,Dankiewicz J,Nielsen N,Rundgren M,Smith JG,Hertel S,Struck J,Friberg H

    更新日期:2014-04-01 00:00:00

  • A catheter technique in ophthalmic regional anaesthesia. Cadaver experiments.

    abstract:BACKGROUND:Regional anaesthesia for ophthalmic surgery is generally accomplished by peri- or retrobulbar techniques. Depending on the duration of ophthalmic surgery, reblock might become necessary. Our goal was to invent a catheter technique for ophthalmic regional anaesthesia that enables the user to administer local ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1034/j.1399-6576.2000.440416.x

    authors: László CJ,Gombos K,Vimláti L,Salacz G,Hatvani I

    更新日期:2000-04-01 00:00:00

  • Effects of propranolol pretreatment on cerebral blood flow, oxygen uptake and catecholamines during metabolic acidosis following E. coli endotoxin in dogs.

    abstract::After an intravenous injection of E. coli endotoxin in dogs a decrease in cerebral blood flow (CBF) and an increase in cerebral metabolic rate of oxygen (CMRo2) have been shown to occur. In metabolic acidosis following endotoxin CMRo2 increased with decreasing pH. A possible explanation for the increased CMRo2 after e...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1995.tb04101.x

    authors: Westerlind A,Larsson LE,Häggendal J,Ekström-Jodal B

    更新日期:1995-05-01 00:00:00

  • Prolonged dysequilibrium between blood and brain concentrations of propofol during infusions in sheep.

    abstract:BACKGROUND:Previous work had shown dysequilibrium between the arterial blood and brain concentrations of the intravenous anaesthetic agent propofol following its rapid administration over 2 min to sheep. The extent of dysequilibrium was examined following slower administration as a constant rate 45-min infusion (10 mg/...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1034/j.1399-6576.1999.430215.x

    authors: Ludbrook GL,Upton RN,Grant C,Martinez A

    更新日期:1999-02-01 00:00:00

  • Effects of prolonged anesthesia with enflurane or halothane on renal function in dogs.

    abstract::Elevated serum inorganic fluoride levels (60-300 mumol/l), maintained over 6 h, influenced renal function in beagle dogs. Changes in water reabsorption were seen with an increased urine flow and free water clearance and decreased urinary concentration capacity. Possible nephrotoxicity as an effect of inorganic fluorid...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1981.tb01642.x

    authors: Wickström I,Stefansson T

    更新日期:1981-06-01 00:00:00

  • Circulatory effects of short-term hypercapnia during thoracolumbar epidural anaesthesia.

    abstract::In ten elderly patients subjected to extensive thoracolumbar epidural anaesthesia, circulatory changes were studied before and during sympathetic stimulation. Induced hypercapnia was used as a sympathetic stimulus. After establishment of the epidural anaesthesia, which extended from T1 to L2, there were decreases in h...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1987.tb02536.x

    authors: Sundberg A,Wattwil M,Wiklund L

    更新日期:1987-02-01 00:00:00

  • Washout of sevoflurane from the GE Avance and Amingo Carestation anesthetic machines.

    abstract:BACKGROUND:Inhalational anesthetics must be removed from anesthetic machines to prevent malignant hyperthermia (MH) in susceptible patients or to treat MH occurring during inhalational general anesthesia. This study examines the sevoflurane washout from the GE Avance and Amingo Carestations™. METHODS:The care stations...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2011.02506.x

    authors: Brünner HW,Pohl S,Grond S

    更新日期:2011-10-01 00:00:00

  • Perivascular axillary block VI: the distribution of gelatine solution injected into the axillary neurovascular sheath of cadavers.

    abstract::Axillary perivascular injection of 50 ml blue-stained gelatine was made in 20 cadavers, and a total dissection of the axilla was performed. The distribution of injected gelatine and the contact between nerves and gelatine were examined on cross-sections of the neurovascular bundle. The spread of gelatine was character...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1986.tb02359.x

    authors: Vester-Andersen T,Broby-Johansen U,Bro-Rasmussen F

    更新日期:1986-01-01 00:00:00

  • Triage and mortality in 2875 consecutive trauma patients.

    abstract:BACKGROUND:Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage. METHODS:We prospectively registered all trauma patients in Eastern Denmark over 12 consecutive months. We analysed the ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2009.02075.x

    authors: Meisler R,Thomsen AB,Abildstrøm H,Guldstad N,Borge P,Rasmussen SW,Rasmussen LS

    更新日期:2010-02-01 00:00:00

  • Serum cholinesterase activity in burned patients. II: anaesthesia, suxamethonium and hyperkalaemia.

    abstract::The importance of serum cholinesterase activity in burned patients was evaluated in relation to anaesthesia. Anaesthesia included a repeated administration of suxamethonium. Thirty-two patients with an estimated area of burn between 3 and 72% were studied during 39 anaesthetic procedures. A statistically significant i...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1975.tb05237.x

    authors: Viby-Mogensen J,Hanel HK,Hansen E,Graae J

    更新日期:1975-01-01 00:00:00

  • Adenosine infusion during isoflurane-nitrous oxide anaesthesia: indications of perioperative analgesic effect.

    abstract::Adenosine, an endogenous compound with a known antinociceptive effect when administered into the CNS, was applied in nine patients (21-65 years) by the peripheral intravenous route (70-130 micrograms.kg-1.min-1) as a replacement for peroperative opioids during inhalation anaesthesia for surgical procedures not requiri...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1992.tb03526.x

    authors: Sollevi A

    更新日期:1992-08-01 00:00:00

  • Lung function during anesthesia and respiratory insufficiency in the postoperative period: physiological and clinical implications.

    abstract::This review covers the physiological and clinical implications of lung function during anesthesia and respiratory insufficiency in the postoperative period. We have divided it into 3 main sections: 1) lung function changes induced by anesthesia and surgery, in which the impact on pulmonary mechanics, ventilation/perfu...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-6576.1989.tb02960.x

    authors: Schwieger I,Gamulin Z,Suter PM

    更新日期:1989-10-01 00:00:00

  • Point-of-care analyses of blood samples from intraosseous access in pre-hospital critical care.

    abstract:BACKGROUND:Intraosseous (IO) access is used for fluid and medication administration in emergency situations when difficulties with vascular access are encountered. IO access would be readily available to take samples for point-of-care (POC) analysis, but there is scarce evidence about the reliability of POC analysis of...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.13443

    authors: Jousi M,Björkman J,Nurmi J

    更新日期:2019-11-01 00:00:00

  • Ethical issues in intensive care--a survey among Scandinavian intensivists.

    abstract:BACKGROUND:The general principles of medical ethics are universally accepted. In practice, however, there is variation on how these principles are interpreted by people with different cultural backgrounds. The aim of this study was to document the views of Scandinavian intensive care physicians on intensive care unit (...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2005.00799.x

    authors: Tallgren M,Klepstad P,Petersson J,Skram U,Hynninen M

    更新日期:2005-09-01 00:00:00

  • Echocardiographic features, mortality, and adrenal function in patients with cirrhosis and septic shock.

    abstract:OBJECTIVES:Cirrhosis of the liver is associated with an increased susceptibility to bacterial infections capable of causing septic shock and with a basal hyperdynamic circulatory state. The primary objective of this study was to delineate the echocardiographic characteristics and outcomes of septic shock in patients wi...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2007.01491.x

    authors: Thierry S,Giroux Leprieur E,Lecuyer L,Brocas E,Van de Louw A

    更新日期:2008-01-01 00:00:00

  • Platelet gel and fibrin sealant reduce allogeneic blood transfusions in total knee arthroplasty.

    abstract:BACKGROUND:Total knee arthroplasty (TKA) is often associated with a considerable amount of post-operative blood loss, necessitating the transfusion of allogeneic blood, which can add to the complications. Optimization of strategies to reduce the need for blood transfusion is desired. This study was designed to evaluate...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1399-6576.2006.001005.x

    authors: Everts PA,Devilee RJ,Brown Mahoney C,Eeftinck-Schattenkerk M,Box HA,Knape JT,van Zundert A

    更新日期:2006-05-01 00:00:00

  • Haemodynamic and metabolic effects of resuscitation with Ringer's ethyl pyruvate in the acute phase of porcine endotoxaemic shock.

    abstract:BACKGROUND:Ethyl pyruvate has been shown to possess anti-inflammatory and free radical scavenging properties. However, the haemodynamic effects of ethyl pyruvate have not been studied in detail. We investigated the systemic, regional and microcirculatory haemodynamic and metabolic effects of resuscitation with Ringer's...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2006.01140.x

    authors: Andersson A,Fenhammar J,Frithiof R,Sollevi A,Hjelmqvist H

    更新日期:2006-11-01 00:00:00

  • Pulmonary complications, ventilation and blood gases after upper abdominal surgery.

    abstract::Forty patients who underwent elective cholecystectomy were examined preoperatively and during the first postoperative week by physical examination, measurement of FVC and FEV1, arterial pH and blood gas analyses, and chest x-ray. Postoperative pulmonary complications (p.p.c.) were detected in 30 (75%) of the patients....

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1977.tb01211.x

    authors: Hansen G,Drablos PA,Steinert R

    更新日期:1977-01-01 00:00:00

  • Infusion of albumin attenuates changes in serum protein binding of drugs in surgical patients compared with volume replacement with HAES.

    abstract:BACKGROUND:In vitro studies have indicated that stabilizers present in pharmaceutical-grade albumin influence albumin-binding capacity for highly protein bound drugs. METHODS:A randomized study including 40 surgical patients, treated with either albumin or starch solutions, was performed. Volumes of colloids were give...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.2007.01555.x

    authors: Reine PA,Kongsgaard UE,Andersen A,Thøgersen AK,Olsen H

    更新日期:2008-03-01 00:00:00

  • Changes in the auditory evoked potentials index by induction doses of four different intravenous anesthetics.

    abstract:BACKGROUND:Many studies have investigated the electroencephalographic changes during the induction and maintenance of anesthesia. However, no comparative studies have been performed on the effects of intravenous anesthetics on the auditory evoked potentials index (AAI). The present study was performed to compare the ch...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1399-6576.2005.00820.x

    authors: Nishiyama T

    更新日期:2005-10-01 00:00:00