How to Cite
Abstract
The coming of new drugs is a challenge for the anesthesiologist, many of these they turn out to be effective, others are without being able to demonstrate the benefits for the patient. It becomes necessary through the clinical investigation to give him evidences to each one of them. The Dexmedetomidine and the Remifentanyl they are two drugs of recent introduction in anesthesia and their effects in the patient neurosurgical they have not been completely described. Objectives: The major goal of this study was to evaluate the hemodynamic changes during the three phases of the anesthesia using fentanyl and sevoflurane compared with dexmedetomidine, remifentanyl and sevoflurane (DRS) to dose smaller than 1 CAM. A secondary goal was to compare times of extubación, sedation, postoperative analgesia and costs.Patient and Methods: Prospective study not randomized in 50 patients ASA I,II,III between 18 and 80 years, subjected to craniectomía. Patients were divided into one of two groups: Group FS (n=25) and DRS (n=25). The relative risk was evaluated (RR) of presenting hypertension, hypotension, taquicardia, bradicardia, sedation and postoperative analgesia. Results: The statistical analysis did not show differences regarding sex, age or ASA classification between two groups. Group DRS Patients presenting taquicardia and hypertension was smaller and more significant in the intervened group (RR 0.625 and 0.357 p=0.041 and 0.009). The time to the extubación was smaller in the intervened group (6,8 vs 13,6min. p=0,000), with a level Ramsey 3 in 96% (n=24) versus 12% (n=3) in the group control (p=0,000). The postoperative pain was given in 54% of the group control and alone in 4% of the one intervened (p=0,000). Conclusion: The dexmedetomidina and the Remifentanyl are two promissory drugs that give us the opportunity to complete the objectives of the anesthesia neurosurgical better and they should be evaluated in future controlled clinical studies disease and in people older than 60 years, the underlying neoplasm and cases of unknown etiology prevail. The anticoagulant treatment is effective and safe. The prognosis was excellent in the most of the cases. (MÉD.UIS. 2010;23(2):86-92).
Key words: anesthesia craniotomy. Dexmedetomidina. Remifentanyl.
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