Remifentanil does not increase urine output during oral surgery, contrary to its effect during other surgeries - a cohort study

Kentaro Ouchi; Kazuna Sugiyama

doi:10.1016/j.bjane.2015.12.004

Scientific Article

Remifentanil does not increase urine output during oral surgery, contrary to its effect during other surgeries - a cohort study

Remifentanil não aumenta a diurese durante cirurgia oral, contrariamente ao seu efeito durante outras cirurgias - estudo de coorte

Kentaro Ouchi; Kazuna Sugiyama

http://dx.doi.org/10.1016/j.bjane.2015.12.004 Braz J Anesthesiol, vol.67, n4, p.342-346, 2017

PDF

Downloads: 0

Abstract

Abstract Background: An increase in urine output by remifentanil injection during laparoscopic procedures and surgeries such as cardiac and gynecological procedures, due to suppression of the stress response to surgery, has been reported. The aim of our prospective, observational, cohort study was to assess the effect of remifentanil analgesia on urine output during dental and minor oral surgery by comparing intraoperative urine output under defined infusion volumes with and without the use of remifentanil. Methods: Dental patients aged 16 years or older, American Society of Anesthesiologists physical status 1, with no renal diseases or abnormal blood values of serum creatinine and BUN, not on treatment with diuretic drugs, and undergoing minor oro-maxillofacial surgery or dental treatment under inhalation general anesthesia were included in this study. Urethral catheterization was performed after anesthesia induction, and urine output was measured every 30 minutes. We measured urine volume (mL) and rate of urine output (mL.kg-1.h-1) intraoperatively, and compared these parameters between patients who did and did not receive remifentanil during the intraoperative period. Results: Eighty-seven patients were categorized into the remifentanil group (n = 43) or remifentanil non-use group (n = 44). Both volume of urine (mL) and rate of urine output (mL.kg-1.h-1) were not significantly different between the two groups (remifentanil group, 372.3 ± 273.5 mL, 1.8 ± 1.1 mL.kg-1.h-1; remifentanil non-use group, 343.3 ± 283.3 mL, 1.9 ± 1.2 mL.kg-1.h-1; p = 0.63; 0.57). Conclusion: Our results show that use of remifentanil during dental and minor oral surgeries does not increase urine output.

Keywords

Remifentanil, Urine output, General anesthesia

Resumo

Resumo Justificativa: Foi relatado um aumento na diurese após a injeção de remifentanil durante procedimentos laparoscópicos e cirurgias cardíacas e ginecológicas, devido à supressão da resposta ao estresse da cirurgia. O objetivo de nosso estudo prospectivo, observacional e de coorte foi avaliar o efeito da analgesia com remifentanil sobre a diurese durante cirurgia odontológica e oral de pequeno porte e comparar a diurese no intraoperatório sob infusão de volumes definidos, com e sem o uso de remifentanil. Métodos: Pacientes odontológicos ≥ 16 anos, estado físico ASA I, sem doenças renais ou valores sanguíneos anormais de creatinina sérica e ureia, sem tratamento com diuréticos e submetidos à cirurgia bucomaxilofacial de pequeno porte ou tratamento odontológico sob anestesia geral inalatória foram incluídos neste estudo. Cateterismo uretral foi feito após a indução da anestesia e a diurese foi medida a cada 30 min. Medimos o volume de urina (mL) e a taxa de diurese (mL.kg-1.h-1) no intraoperatório e comparamos esses parâmetros entre os pacientes que receberam e que não receberam remifentanil durante o período intraoperatório. Resultados: Foram designados 87 pacientes para os grupos com remifentanil (n = 43) ou grupo sem remifentanil (n = 44). O volume de urina (mL) e a taxa de diurese (mL.kg-1.h-1) não foram significativamente diferentes entre os dois grupos (grupo com remifentanil: 372,3 ± 273,5 mL, 1,8 ± 1,1 mL.kg-1.h-1; grupo sem remifentanil: 343,3 ± 283,3 mL, 1,9 ± 1,2 mL.kg-1.h-1; p = 0,63; 0,57). Conclusão: Nossos resultados mostram que o uso de remifentanil durante as cirurgias odontológicas e de pequeno porte não aumenta a diurese.

Palavras-chave

Remifentanil, Diurese, Anestesia geral

References

Ishikawa K, Sakai A, Nagata H. Remifentanil increases urine output in patients undergoing laparoscopic colectomy. Masui. 2012;61:526-30.

Myles PS, Hunt JO, Fletcher H. Remifentanil, fentanyl, and cardiac surgery: a double-blinded, randomized, controlled trial of costs and outcomes. Anesth Analg. 2002;95:805-12.

Onaka M, Yamamoto H. Remifentanil may be beneficial to urinary output under epidural-based general anesthesia. Masui. 2010;59:1391-5.

Yago Y, Tajiri O, Ito H. Effect of remifentanil on urine output during gynecological laparoscopic surgery. Masui. 2009;58:613-5.

Kawai M, Nakata J, Kawaguchi M. Comparison of urinary output during general anesthesia, between patients administered with remifentanil and those without remifentanil administration. Masui. 2010;59:179-82.

Myre K, Raeder J, Rostrup M. Catecholamine release during laparoscopic fundoplication with high and low doses of remifentanil. Acta Anaesthesiol Scand. 2003;47:267-73.

Marana E, Scambia G, Colicci S. Leptin and perioperative neuroendocrine stress response with two different anaesthetic techniques. Acta Anaesthesiol Scand. 2008;52:541-6.

Winterhalter M, Brandl K, Rahe-Meyer N. Endocrine stress response and inflammatory activation during CABG surgery. A randomized trial comparing remifentanil infusion to intermittent fentanyl. Eur J Anaesthesiol. 2008;25:326-35.

Lalonde DH, Price C, Wong AL. Minimally painful local anesthetic injection for cleft lip/nasal repair in grown patients. Plast Reconstr Surg Glob Open. 2014;2:e171.

Kim JE, Lee JS, Kim MK. Nicardipine infusion for hypotensive anesthesia during orthognathic surgery has protective effect on renal function. J Oral Maxillofac Surg. 2014;72:41-6.

Ashton N, Balment RJ, Blackburn TP. Kappa-opioid-induced changes in renal water and electrolyte management and endocrine secretion. Br J Pharmacol. 1989;97:769-76.

Santi M, Lava SA, Camozzi P. The great fluid debate: saline or so-called "balanced" salt solutions?. Ital J Pediatr. 2015;41:47.

Mehra P, Arya V. Temporomandibular joint arthrocentesis: outcomes under intravenous sedation versus general anesthesia. J Oral Maxillofac Surg. 2015;73:834-42.

Remifentanil does not increase urine output during oral surgery, contrary to its effect during other surgeries - a cohort study

Remifentanil não aumenta a diurese durante cirurgia oral, contrariamente ao seu efeito durante outras cirurgias - estudo de coorte

Kentaro Ouchi; Kazuna Sugiyama

Abstract

Keywords

Resumo

Palavras-chave

References

Links

Share

Braz J Anesthesiol