Sedative and analgesic effects of remifentanil combined with prapofol administered by TCI versus intravenous infusion during local anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To compare the sedative and analgesic effects of remifentanil combined with propofol administered by target-controlled infusion(TCI)and intravenous infusion during local anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-55 yr,with body mass index ＜ 30 kg/m2,scheduled for plastic surgery under local anesthesia,were equally and randomly divided into TCI group(group T)and intravenous infusion group (group V).Remifentanil(the initial target plasma concentration 1.0 ng/ml)and propofol(the initial target plasma concentration 1.0 ng/ml)were given by TCI before local anesthesia in group T.Remifentanil was infused at a rate of 0.05 μg·kg-1 ·min-1 after a loading dose of 0.25 μg/kg and propofol was infused at a rate of 3 mg·kg-1 ·h-1 after a loading dose of 0.5 mg/kg in group V.The target plasma concentration or infusion rate was adjusted to maintain the modified OAA/S score of 2 or 3.Hypoxemia,bradypnea and/or apnea were recorded during operation.The total amount of remifentanil and propofol consumed was calculated.Results Compared with group V,the incidence of hypoxemia,bradypnea and/or apnea were significantly decreased during operation,and the total amount of remifentanil and propofol consumed was significantly reduced in group T(P ＜ 0.05).Conclusion The sedative and analgesic effects of remifentanil combined with propofol given by TCI are superior to those given by intravenous infusion during local anesthesia,with better safety.