A Comparative Study of the RecoveryCharacteristics for the Use of Propofol-Remifentanil Anesthesia or Sevoflurane-Remifentanil Anesthesia under Bispectral Index Guidance

ABSTRACT

BACKGROUND: The bispectral index (BIS) is a measure of the hypnotic component of anesthesia and can be used to guide the administration of anesthetics. This study compares the emergence and recovery characteristics of total intravenous anesthesia using propofol/remifentanil with sevoflurane/remifentanil anesthesia under bispectral index guidance. METHODS: Fifty-six patients (ASA 1, 2) were randomly assigned to two groups, receiving either propofol/ remifentanil (Group P) or sevoflurane/remifentanil (Group S) anesthesia. Following induction with propofol and remifentanil, anesthesia was maintained with propofol/remifentanil or sevoflurane/ remifentanil. After the induction of anesthesia, the target effect-site concentration of remifentanil was constantly maintained at 3 ng/ml. Propofol and sevoflurane administration was guided using the bispectral index (40-60). Thirty minutes before the end of surgery, ketorolac was administered (0.5 mg/kg intravenously). At the end of surgery, the anesthetic agents were discontinued. Patients in the groups were compared for recovery characteristics (eye opening, response to command, extubation, orientation, time in the Operating room after the end of surgery, Aldrete score >9) using the unpaired t-test (P < 0.05). RESULTS: There were no significant differences in the demographic data between patients in the two groups. Recovery data was not different between the two groups. CONCLUSIONS: BIS-guided anesthesia with propofol or sevoflurane plus remifentanil both provided satisfactory anesthesia for lower abdominal surgery in gynecologic patients.