Anesthesia-induced Negative Hemodynamic Effects
Conditions
Brief summary
Remifentanil is a widely used potent intravenous opioid with the advantage of having a short time of action. Compared to other opiates however remifentanil generates more intense hemodynamic side-effects. In ophthalmic surgery the specific anesthesiological challenges necessitate the administration of a combination of relatively high doses of analgesics on the one hand and a short time for postoperative recovery from anesthesia on the other. For these reasons, anesthetic management often consists of a combination of relatively high doses of propofol and remifentanil. A primary concern during this deep propofol/remifentanil anesthesia is preserving hemodynamic stability and adequate tissue oxygenation. Previous research of the investigators group has revealed that atropine has an exceptionally beneficial effect on hemodynamics as well as on tissue oxygenation. Therefore, the investigators hypothesize that administration of intravenous atropine during induction of propofol/remifentanil may have a positive effect on the hemodynamic profile and peripheral and cerebral tissue oxygenation during and after induction of anesthesia.
Interventions
DRUGPlacebo
Saline
DRUGAtropine
Atropine
Sponsors
University Medical Center Groningen
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients requiring general anaesthesia; * Patient's age ≥ 18 years and older; * Patient and surgical procedure appropriate for treatment with either sufentanil or remifentanil.
Exclusion criteria
* Patient's refusal; * Pregnancy; * Patient's age \< 18 years; * Patients in which atropine is contra-indicated, such as severe aortic valve stenosis, hypertrophic cardiomyopathy or coronary artery disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cardiac output | During anesthesia |
| Peripheral tissue oxygen saturation | During anesthesia |
| Cerebral tissue oxygen saturation | During anesthesia |
Secondary
| Measure | Time frame |
|---|---|
| Systemic vascular resistance | During anesthesia |
| Heart rate | During anesthesia |
| Mean arterial blood pressure | During anesthesia |
Countries
Netherlands
Outcome results
None listed