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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Comparison of Different Anesthetic Regimens in Patients Undergoing Laparoscopic Adjustable Gastric Banding Operations: A Prospective Randomized Trial

1
Faculty of Medicine, Vilnius University
2
Clinic of Anesthesiology and Reanimatology, Vilnius University Hospital Santariškių Klinikos
3
Clinic of Gastroenterology, Nefrourology and Surgery, Vilnius University Hospital Santariškių Klinikos
4
Department of Pulmonology and Immunology, Medical Academy, Lithuanian University of Health Sciences, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2012, 48(12), 89; https://doi.org/10.3390/medicina48120089
Received: 3 November 2011 / Accepted: 30 October 2012 / Published: 4 November 2012
Background and Objective. Obesity is a multisystem disorder, particularly involving the respiratory and cardiovascular systems; therefore, a multidisciplinary approach is required. In spite of widespread performance of weight reduction (bariatric) surgeries, information regarding the anesthetic care of morbidly obese patients is scarce. The aim of this study was to compare the impact of fentanyl and remifentanil on the time of recovery, breathing parameters, and postoperative pain in morbidly obese patients undergoing laparoscopic adjustable gastric banding operations.
Material and Methods
. In this prospective randomized study, 66 morbidly obese patients (BMI>35 kg/m2), aged between 24 and 70 years, scheduled for a laparoscopic adjustable gastric banding operation were divided into 2 groups based on the opioid used for anesthesia: group 1 whose who received remifentanil; and group 2, fentanyl). The following parameters were recorded: peripheral blood oxygenation (SpO2) while breathing room air at baseline and 5 minutes after preoxygenation (100%); end-tidal carbon dioxide pressure at designated time points during the procedure; time to extubation; SpO2 in the postanesthesia care unit; and pain intensity (using the visual analogue scale); and the presence of nausea and vomiting.
Results. The time to extubation was shorter in the remifentanil group, but there was no significant difference in the time to discharge from the postanesthesia care unit. The recovery of respiratory parameters to the baseline values was better and faster in the remifentanil group. The intensity of postoperative pain was similar in both groups (VAS, <3)
Conclusions
. Remifentanil showed good analgesic properties during laparoscopic gastric banding surgery. Postanesthesia recovery and return of respiratory parameters to the baseline values was faster when remifentanil was used. Postoperative pain and the rate of opioid-induced side effects after analgesia with remifentanil were similar as after anesthesia with a longer acting opioid, fentanyl. Despite the problem widely discussed in literature about remifentanil-induced hyperalgesia, no cases of analgesic overconsumption were registered in our study.
Keywords: morbid obesity; laparoscopic adjustable gastric banding operation; respiratory function; remifentanil-induced hyperalgesia; reverse Trendelenburg position morbid obesity; laparoscopic adjustable gastric banding operation; respiratory function; remifentanil-induced hyperalgesia; reverse Trendelenburg position
MDPI and ACS Style

Kontrimavičiūtė, E.; Šipylaitė, J.; Aksionova, D.; Cincilevičiūtė, G.; Brimas, G. Comparison of Different Anesthetic Regimens in Patients Undergoing Laparoscopic Adjustable Gastric Banding Operations: A Prospective Randomized Trial. Medicina 2012, 48, 89.

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