견관절경 수술동안 Desflurane 흡입마취 시 혈역학에 대한 Remifentanil 효과

Abstract

Although arthroscopic shoulder surgery are regarded as minor operation, we often experienced intraoperative hemodynamic unstability. Intraoperative combinations of volatile and opioid agents are used to achieve hemodynamic stability. This study described the influence of different remifentanil concentration on hemodynamic stability when received inhalation anesthesia with desflurane during arthroscopic shoulder surgery. Forty five patients (ASA class 1 and 2) undergoing elective arthroscopic shoulder surgery were randomly allocated to three groups. The breathing circuit was primed with 6 vol% desflurane in 1.5 L/min each N2O and O2. Anesthesia was induced with intravenous thiopental sodium 5 mg/kg , rocuronium 0.6 mg/kg. 1 minute after rocuronium injection, either 20 ml/hr saline(group C), or 0.05 μg/kg/min remifentanil(group R1), 0.1 μg/kg/min remifentanil(group R2) was infused continuously and then the hemodynamics were recorded. The hemodynamics were significantly more stable in group R1 and R2 than C (P < 0.05), but the hypotension and bradycardia were more observed in group R2 than R1. Remifentanil 0.05 μg/kg/min was more effective for controlling the hemodynamic changes during shoulder arthroscopic surgery.

Key Words : arthroscopic shoulder surgery, desflurane, hemodynamics, remifentanil