Effect of Acute Arterial Hypertension on Morphine's Requirements and Postsurgical Pain.
Hypertensive Disease, Pain, Postoperative
About this trial
This is an interventional supportive care trial for Hypertensive Disease focused on measuring analgesia, postoperative;, analgesics opioid;, hyperalgesia;, remifentanil;, hypertension.
Eligibility Criteria
Inclusion Criteria:
- American Society of Anesthesiology patient classification status(ASA) I-II
- Between 20 and 60 years of age
- Programed for elective laparoscopic cholecystectomy
Exclusion Criteria:
- History of arterial hypertension
- Baseline blood pressure over 139/89
- Use of opioids and any analgesic drug during the last 24 hours before surgery
- Chronic use of nonsteroidal antiinflammatory
- BMI > 34.9
- History of drug or alcohol abuse
- Use of medications that interfere in the central nervous system
- Adverse reactions to the drugs used in the study
- Pregnancy
Sites / Locations
- Hospital Clinico Pontificia Universidad Catolica
Arms of the Study
Arm 1
Arm 2
Other
Other
SBP 20-30% under baseline
SBP 20-30% over baseline
Induction of anesthesia was performed with remifentanil, pentothal 3 mg/kg and atracurium 0.5 mg/Kg. Anaesthesia was maintained with remifentanil (0.4 ug/Kg/min) and isoflurane adjusted to bispectral index (40-60). Patients received a phenylephrine infusion to maintain systolic blood pressure (SBP) 20% to 30% under baseline. The lower limit of SBP was 75 mmHg. In the recovery room, morphine was administered routinely at doses of 3 mg IV every 15 minutes until pain was less than 4 estimated by visual analog scale (VAS). VAS and pain threshold with von Frey filaments were assessed at 2, 6, 12 and 24 postoperative hours. All patients, received ketorolac 30 mg IV every 8 hours and intravenous morphine administered by patient controlled analgesia system (PCA) during the first 24 hours.
Induction of anesthesia was performed with remifentanil, pentothal 3 mg/kg and atracurium 0.5 mg/Kg. Anaesthesia was maintained with remifentanil (0.4 ug/Kg/min) and isoflurane adjusted to bispectral index(40-60). Patients received a phenylephrine infusion in order to maintain systolic blood pressure (SBP) 20% to 30% over baseline. The upper limit of SBP was 165 mmHg. In the recovery room, morphine was administered routinely at doses of 3 mg IV every 15 minutes until pain was less than 4 estimated by visual analog scale (VAS). VAS and pain threshold with von Frey filaments were assessed at 2, 6, 12 and 24 postoperative hours. All patients, received ketorolac 30 mg IV every 8 hours and intravenous morphine administered by patient controlled analgesia system (PCA) during the first 24 hours.