The changes of heart rate, blood pressure and cardiac index in burn surgery under propofol-remifentanil anesthesia and desflurane anesthesia

Kwak, In Suk; Lee, Tae Hyung; Bae, Ji Young; Woo, Chul Ho; Kim, Kwang Min

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2008;3(4):260-263.
Published online October 30, 2008.

The changes of heart rate, blood pressure and cardiac index in burn surgery under propofol-remifentanil anesthesia and desflurane anesthesia

In Suk Kwak, Tae Hyung Lee, Ji Young Bae, Chul Ho Woo, Kwang Min Kim

Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. kwak65@yahoo.co.kr

Abstract

BACKGROUND
Major burns can alter the hemodynamic effect caused by anesthesia. Total intravenous anesthesia induces little hemodynamic change and desflurane has a rapid induction advantage among the different kinds of inhalation anesthesia. The study compared propofol and remifentanil anesthesia with desflurane anesthesia during induction and maintenance anesthesia. METHODS: Forty patients, who were scheduled for burn surgery, were randomly assigned to either Group 1 (n = 20) or Group 2 (n = 20). Group 1 was induced and maintained with an infusion of propofol and remifentanil. After inducing anesthesia with propofol and rocuromium, group 2 was maintained with desflurane. The heart rate and mean arterial pressure, and cardiac index were measured in the operation room, after induction (AI), after intubation (AT) and at 5, 10, 15 and 20 minutes after intubation. RESULTS: There was a significantly lower heart rate in group 1 than in group 2. The heart rate of group 2 showed a significant increase at AI, AT, 5, 10, 15 and 20 minutes after intubation. There was no significant difference in the mean arterial blood pressure and cardiac index between the two groups. CONCLUSIONS: During burn surgery, total intravenous anesthesia was effective in attenuating the hemodynamic effects.

Key Words: burn, desflurane, propofol, remifentanil