Comparison of General Anesthesia using Propofol-Remifentanil and Propofol-Nitrous Oxide / 대한마취과학회지

ABSTRACT

BACKGROUND: Remifentanil is a novel, ultra-short acting opioid. This study was performed to compare the hemodynamic responses of remifentanil and nitrous oxide under propofol-based anesthesia during the intraoperative period. METHODS: Forty patients undergoing gynecologic surgery were randomly allocated to either remifentanil (R group) or N2O group (N group). In the R group, remfentanil was continuously infused from the induction of anesthesia (0.5 microgram/kg/min) to the end of surgery (0.1-0.5 microgram/kg/min). In the N group, fentanyl (2 microgram/kg) was injected intravenously and N2O was used thereafter. In both groups, target-concentration infusion of propofol was applied. We compared mean arterial pressure (MAP) and heart rate (HR) before and after tracheal intubation and during the rest of anesthetic time between the two groups. Postoperative parameters such as nausea/vomiting, consciousness level and pain at 2 and 24 hours were also compared. RESULTS: The magnitude of MAP and HR after tracheal intubation were significantly smaller and more stable in the R group than in the N group. Hypertensive (systolic blood pressure > 140 mmHg) episodes were significantly less frequent in the R group (3.0%) than in the N group (12.4%) during the operation. R group showed less MAP (76+/-12 mmHg) and HR (61+/-10 bpm) compared with those of N group (86+/-17 mmHg, 63+/-8 bpm, P < 0.05 respectively). Other postoperative measures were comparable between the two groups. CONCLUSIONS: We conclude that the continuous infusion of remifentanil can provide more stable hemodynamic status than N2O without significant adverse effects, in propofol-based general anesthesia.