Efficacy of anesthesia with propofol-remifentanil given by target-controlled infusion for thymectomy in patients with myasthenia gravis
10.3760/cma.j.issn.0254-1416.2010.08.008
- VernacularTitle:靶控输注异丙酚复合瑞芬太尼麻醉用于重症肌无力患者胸腺切除术的效果
- Author:
Yu SHI
;
Mingzhang ZUO
- Publication Type:Journal Article
- Keywords:
Propofol;
Remifentanil;
Drug delivery systems;
Myasthenia gravis;
Thymectomy
- From:
Chinese Journal of Anesthesiology
2010;30(8):919-921
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of anesthesia with propofol-remifentanil given by targetcontrolled infusion (TCI) for thymectomy in patients with myasthenia gravis ( MG). Methods Forty-five ASA Ⅰ or Ⅱ MG patients aged 16-64 yr weighing 45-95 kg undergoing thymectomy were studied. Anesthesia was induced with TCI of propofol (target plasma concentration 4 μg/ml) and remifentanil (target effect-site concentration 4 ng/ml). Thracheal intubation was performed after topical anesthesia with 2% lidocaine 2-3 ml and then the patients were mechanically ventilated. Anesthesia was maintained with TCI of propofol ( target plasma concentration 3-5 μg/ml) and remifentail (target effect-site concentration 3-6 ng/ml). Sufentanil 0.15 μg/kg was injected intravenously for analgesia 30 min before operation. The success rate of intubationat at first attempt, body movement in response to skin incision, recovery time, extubation time, extubation condition at the end of operation and cardiovascular events were recorded. Results Thracheal intubation was performed successfully in all patients. The success rate of intubation at first attempt was 100%. No body movement occurred during skin incision in the patients.Recovery time was 1.0-3.2 min and extubation time 2.6-7.0 min. All patients were successfully extubated at the end of operation. Bradycardia developed in 3 patients and hypotension in 4 patients during induction, but they all returned to normal after symptomatic treatment. Bradycardia developed in 3 patients during operation, but returned to normal after symptomatic treatment. Conclusion Anesthesia with TCI of propofol and remifentanil can be used safely and effectively in MG patients undergoing thymectomy.
