Propofol versus alfentanil to prevent movement responses during uterine curettage

E.R.J. Seitsonen, E.-S. Cohen-Laroque, Mark van Gils, K.T. Korttila, P.J. Neuvonen, A.M. Yli-Hankala

Research output: Contribution to journalArticleScientificpeer-review

4 Citations (Scopus)

Abstract

Background: Propofol anaesthesia is frequently associated with movement responses in non‐paralysed patients. Opioids decrease the probability of movement during noxious stimulation. Heart rate variability and frontal electromyography (EMG), which are related to subcortical functions, may be more closely related than surface electroencephalography (EEG) to movement responses to noxious stimulation.

Methods: Eighty‐two patients scheduled for uterine dilatation and curettage were randomized to receive at the first intra‐operative movement either a supplemental alfentanil bolus, 0.5 mg intravenously, or a supplemental propofol bolus, 0.7 mg/kg intravenously. The incidences of recurring movement during the procedure were compared between the two groups. The associations of a measure of heart rate variability (Anemon index), heart rate, EMG and two EEG variables with movement responses were evaluated.

Results: The incidences of recurring movement were 73% and 38% in the alfentanil and propofol groups, respectively [difference, 35%; 95% confidence interval, 9–56%; P= 0.014 between the groups). The Anemon index, heart rate, EMG and surface EEG variables displayed mainly reactive associations with movement responses.

Conclusion: During uterine curettage under propofol–alfentanil–nitrous oxide anaesthesia, a propofol bolus of 0.7 mg/kg was more effective in preventing the recurrence of movement responses than an alfentanil bolus of 0.5 mg. Several physiological variables may be used to track significant arousal reactions, but not to predict them.
Original languageEnglish
Pages (from-to)751-758
JournalActa Anaesthesiologica Scandinavica
Volume51
Issue number6
DOIs
Publication statusPublished - 2007
MoE publication typeA1 Journal article-refereed

Fingerprint

Alfentanil
Curettage
Propofol
Electromyography
Heart Rate
Electroencephalography
Anesthesia
Dilatation and Curettage
Incidence
Arousal
Oxides
Opioid Analgesics
Confidence Intervals
Recurrence

Keywords

  • Alfentanil
  • Anaesthesia
  • Electroencephalography
  • Electromyography
  • Heart rate
  • Intra-operative
  • Monitoring
  • Movement
  • Propofol

Cite this

Seitsonen, E. R. J., Cohen-Laroque, E-S., van Gils, M., Korttila, K. T., Neuvonen, P. J., & Yli-Hankala, A. M. (2007). Propofol versus alfentanil to prevent movement responses during uterine curettage. Acta Anaesthesiologica Scandinavica, 51(6), 751-758. https://doi.org/10.1111/j.1399-6576.2007.01309.x
Seitsonen, E.R.J. ; Cohen-Laroque, E.-S. ; van Gils, Mark ; Korttila, K.T. ; Neuvonen, P.J. ; Yli-Hankala, A.M. / Propofol versus alfentanil to prevent movement responses during uterine curettage. In: Acta Anaesthesiologica Scandinavica. 2007 ; Vol. 51, No. 6. pp. 751-758.
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title = "Propofol versus alfentanil to prevent movement responses during uterine curettage",
abstract = "Background: Propofol anaesthesia is frequently associated with movement responses in non‐paralysed patients. Opioids decrease the probability of movement during noxious stimulation. Heart rate variability and frontal electromyography (EMG), which are related to subcortical functions, may be more closely related than surface electroencephalography (EEG) to movement responses to noxious stimulation.Methods: Eighty‐two patients scheduled for uterine dilatation and curettage were randomized to receive at the first intra‐operative movement either a supplemental alfentanil bolus, 0.5 mg intravenously, or a supplemental propofol bolus, 0.7 mg/kg intravenously. The incidences of recurring movement during the procedure were compared between the two groups. The associations of a measure of heart rate variability (Anemon index), heart rate, EMG and two EEG variables with movement responses were evaluated.Results: The incidences of recurring movement were 73{\%} and 38{\%} in the alfentanil and propofol groups, respectively [difference, 35{\%}; 95{\%} confidence interval, 9–56{\%}; P= 0.014 between the groups). The Anemon index, heart rate, EMG and surface EEG variables displayed mainly reactive associations with movement responses.Conclusion: During uterine curettage under propofol–alfentanil–nitrous oxide anaesthesia, a propofol bolus of 0.7 mg/kg was more effective in preventing the recurrence of movement responses than an alfentanil bolus of 0.5 mg. Several physiological variables may be used to track significant arousal reactions, but not to predict them.",
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Seitsonen, ERJ, Cohen-Laroque, E-S, van Gils, M, Korttila, KT, Neuvonen, PJ & Yli-Hankala, AM 2007, 'Propofol versus alfentanil to prevent movement responses during uterine curettage', Acta Anaesthesiologica Scandinavica, vol. 51, no. 6, pp. 751-758. https://doi.org/10.1111/j.1399-6576.2007.01309.x

Propofol versus alfentanil to prevent movement responses during uterine curettage. / Seitsonen, E.R.J.; Cohen-Laroque, E.-S.; van Gils, Mark ; Korttila, K.T.; Neuvonen, P.J.; Yli-Hankala, A.M.

In: Acta Anaesthesiologica Scandinavica, Vol. 51, No. 6, 2007, p. 751-758.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Propofol versus alfentanil to prevent movement responses during uterine curettage

AU - Seitsonen, E.R.J.

AU - Cohen-Laroque, E.-S.

AU - van Gils, Mark

AU - Korttila, K.T.

AU - Neuvonen, P.J.

AU - Yli-Hankala, A.M.

PY - 2007

Y1 - 2007

N2 - Background: Propofol anaesthesia is frequently associated with movement responses in non‐paralysed patients. Opioids decrease the probability of movement during noxious stimulation. Heart rate variability and frontal electromyography (EMG), which are related to subcortical functions, may be more closely related than surface electroencephalography (EEG) to movement responses to noxious stimulation.Methods: Eighty‐two patients scheduled for uterine dilatation and curettage were randomized to receive at the first intra‐operative movement either a supplemental alfentanil bolus, 0.5 mg intravenously, or a supplemental propofol bolus, 0.7 mg/kg intravenously. The incidences of recurring movement during the procedure were compared between the two groups. The associations of a measure of heart rate variability (Anemon index), heart rate, EMG and two EEG variables with movement responses were evaluated.Results: The incidences of recurring movement were 73% and 38% in the alfentanil and propofol groups, respectively [difference, 35%; 95% confidence interval, 9–56%; P= 0.014 between the groups). The Anemon index, heart rate, EMG and surface EEG variables displayed mainly reactive associations with movement responses.Conclusion: During uterine curettage under propofol–alfentanil–nitrous oxide anaesthesia, a propofol bolus of 0.7 mg/kg was more effective in preventing the recurrence of movement responses than an alfentanil bolus of 0.5 mg. Several physiological variables may be used to track significant arousal reactions, but not to predict them.

AB - Background: Propofol anaesthesia is frequently associated with movement responses in non‐paralysed patients. Opioids decrease the probability of movement during noxious stimulation. Heart rate variability and frontal electromyography (EMG), which are related to subcortical functions, may be more closely related than surface electroencephalography (EEG) to movement responses to noxious stimulation.Methods: Eighty‐two patients scheduled for uterine dilatation and curettage were randomized to receive at the first intra‐operative movement either a supplemental alfentanil bolus, 0.5 mg intravenously, or a supplemental propofol bolus, 0.7 mg/kg intravenously. The incidences of recurring movement during the procedure were compared between the two groups. The associations of a measure of heart rate variability (Anemon index), heart rate, EMG and two EEG variables with movement responses were evaluated.Results: The incidences of recurring movement were 73% and 38% in the alfentanil and propofol groups, respectively [difference, 35%; 95% confidence interval, 9–56%; P= 0.014 between the groups). The Anemon index, heart rate, EMG and surface EEG variables displayed mainly reactive associations with movement responses.Conclusion: During uterine curettage under propofol–alfentanil–nitrous oxide anaesthesia, a propofol bolus of 0.7 mg/kg was more effective in preventing the recurrence of movement responses than an alfentanil bolus of 0.5 mg. Several physiological variables may be used to track significant arousal reactions, but not to predict them.

KW - Alfentanil

KW - Anaesthesia

KW - Electroencephalography

KW - Electromyography

KW - Heart rate

KW - Intra-operative

KW - Monitoring

KW - Movement

KW - Propofol

U2 - 10.1111/j.1399-6576.2007.01309.x

DO - 10.1111/j.1399-6576.2007.01309.x

M3 - Article

VL - 51

SP - 751

EP - 758

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 6

ER -