Target-controlled infusion of propofol combined with remifentanil or fentanyl: A comparison of anesthetic depth / 第二军医大学学报

ABSTRACT

Objective: To compare the anesthetic depth and postoperative recovery of propofol combined with remifentanil or fentanyl when administered through target-controlled infusion (TCI). Methods: Ninety patients receiving elective epigastric surgery were randomly divided into 3 groups PF-A, PF-B and PR group. Through TCI, patients in PF-A group were administered with propofol (3 μg/ml) and fentanyl (2 μg/L), in PF-B group with propofol (3 μg/ml) and fentanyl (4 μg/L initially and 2 μg/L after intubation), and in PR group with propofol (3 μg/ml) and remifentanil (6 μg/L). Vital signs (including mean aortic pressure and heart rate) and bispectral index values were recorded pre-anesthesia, pre- and post-intubation, post-incision and during operation in 3 groups. Results: In PF-A group, post-intubation MAP and HR were significantly higher than those of pre-intubation (P<0.05), with obvious stress response during intubation. Whereas there was no significant difference in all parameters between those pre-intubation and post-incision. The vital signs maintained stable during anesthesia and operation in PF-B and PR groups. There was no significant difference in BIS values between 3 groups. During recovery phase the awakening time of PR group was significantly shorter than those of PF-A and PF-B groups. Conclusion: Clinical administration of 4 μg/L fentanyl or 6 μg/L remifentanil can effectively suppress the hemodynamic response to tracheal intubation and incision in propofol TCI anesthesia. However, 2 μg/L fentanyl is only enough to suppress the response to incision but not to intubation.