Metabolic and hemodynamic changes during recovery and tracheal extubation in neurosurgical patients: immediate versus delayed recovery.

Détails

ID Serval
serval:BIB_D042DD6DD1FA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Metabolic and hemodynamic changes during recovery and tracheal extubation in neurosurgical patients: immediate versus delayed recovery.
Périodique
Anesthesia and analgesia
Auteur(s)
Bruder N., Stordeur J.M., Ravussin P., Valli M., Dufour H., Bruguerolle B., Francois G.
ISSN
0003-2999
Statut éditorial
Publié
Date de publication
1999
Peer-reviewed
Oui
Volume
89
Numéro
3
Pages
674-8
Langue
anglais
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial - Publication Status: ppublish
Résumé
Delayed recovery has been advocated to limit the postoperative stress linked to awakening from anesthesia, but data on this subject are lacking. In this study, we measured oxygen consumption (V(O2)) and plasma catecholamine concentrations as markers of postoperative stress. We tested the hypothesis that delayed recovery and extubation would attenuate metabolic changes after intracranial surgery. Thirty patients were included in a prospective, open study and were randomized into two groups. In Group I, the patients were tracheally extubated as soon as possible after surgery. In Group II, the patients were sedated with propofol for 2 h after surgery. V(O2), catecholamine concentration, mean arterial pressure (MAP), and heart rate (HR) were measured during anesthesia, at extubation, and 30 min after extubation. V(O2) and noradrenaline on extubation and mean V(O2) during recovery were significantly higher in Group II than in Group I (V(O2) for Group I: preextubation 215 +/- 46 mL/min, recovery 198 +/- 38 mL/min; for Group II: preextubation 320 +/- 75 mL/min, recovery 268 +/- 49 mL/min; noradrenaline on extubation for Group I: 207 +/- 76 pg/mL, for Group II: 374 +/- 236 pg/ mL). Extubation induced a significant increase in MAP. MAP, HR, and adrenaline values were not statistically different between groups. In conclusion, delayed recovery after neurosurgery cannot be recommended as a mechanism of limiting the metabolic and hemodynamic consequences from emergence from general anesthesia. IMPLICATIONS: In this study, we tested the hypothesis that delayed recovery after neurosurgery would attenuate the consequences of recovery from general anesthesia. As markers of stress, oxygen consumption and noradrenaline blood levels were higher after delayed versus early recovery. Thus, delayed recovery cannot be recommended as a mechanism of limiting the metabolic and hemodynamic consequences from emergence after neurosurgery.
Mots-clé
Aged, Anesthesia Recovery Period, Biological Markers, Blood Pressure, Catecholamines, Double-Blind Method, Female, Heart Rate, Hemodynamics, Humans, Intubation, Intratracheal, Male, Middle Aged, Neurosurgical Procedures, Oxygen Consumption, Postoperative Complications, Prospective Studies, Stress, Physiological
Pubmed
Web of science
Création de la notice
17/01/2008 16:20
Dernière modification de la notice
20/08/2019 15:50
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