An Evaluation of the Performance of Remifentanil Target-Controlled Infusion System Under Inhalation and Intravenous Anesthesia / 中国微创外科杂志

ABSTRACT

Objective To evaluate the performance of the remifentanil target-controlled infusion(TCI) system(Minto model) during laparoscopic surgery under inhalation and intravenous anesthesia.Methods A total of 15 patients scheduled for laparoscopic surgery received remifenanil by TCI,and the anesthesia was maintained with inhalation of isoflurane and intermittent intravenous vecuronium.The target remifentanil plasma concentration(Cp) was increased step by step,with the concentration changed at intervals of 30 minutes.The beginning Cp was 3 ng/ml,then increased to 6 ng/ml,9 ng/ml.Blood samples were taken from radial arterial before anesthesia induction and 30 minutes after adjustment of Cp to determine the concentration of remifentanil using high performance liquid chromatography-tandem mass spectrometry(HPLC/MS/MS).The performance of the TCI system was evaluated by median performance error(MDPE),median absolute performance error(MDAPE) and wobble.Results The MDPE,MDAPE and wobble of the remifentanil TCI system were 8.78%,16.11% and 14.55%,respectively.The measured concentrations of remifentanil were positively correlated with Cp(r=0.891,P=0.000).The linear equation was Y∧ =1.1046X+0.1837.Conclusions The remifentanil TCI system with Minto pharmacokinetic model can meet the requirements of clinical anestehesia for Chinese patients within clinical treating concentration.