The efficacy and safety of target-controlled propofol-remifentanil infusion targeting effect-site vs plasma
- VernacularTitle:两种靶控方法输注异丙酚和瑞芬太尼的安全性和有效性比较
- Author:
Jie YI
;
Tiehu YE
;
Ailun LUO
- Publication Type:Journal Article
- Keywords:
Piperidines;
Propofol;
Drug delivery systems;
Feasibility studies
- From:
Chinese Journal of Anesthesiology
1994;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of anesthetizing patients with propofol-remifentanil given by TCI targeting effect-site vs plasma. Methods Forty-four ASA Ⅰ - Ⅱ patients aged 20 -65 yr undergoing laparascopic cholecystectomy were randomly divided into two groups : group P targeting plasma concentration (n = 22) and group E targeting effect-site concentration ( n - 22) . The patients were given midazolam 1 mg and scopolamine 0.3 nig i. v. in the operating room before anesthesia. Auditory evoked potential, BP, HR and SpO2 monitoring were started before induction of anesthesia. Anesthesia was induced with propofol and remifentanil given by TCL using two Graseby 3500 infusion pumps. The target concentration of propofol was set at 4 ?g ? ml-1 and remifentanii at 2 ng ? ml -1 . Remifentanil infusion was started 2 min before propofol infusion. When the patients lost consciousness (no response to patting and request for eye-opening), succinylcholine 2 mg?kg-1 was given i. v. to facilitate intubation. Intubation score was assessed. The time required for loss of consciousness after TCI of propofol was started (TLOC), the amount of propofol and remifentanil infused and auditory evoked potential index (AAIs) when the patients lost consciousness were recorded. The patients were mechanically ventilated (VT 8-10 ml, RR 10 bpm) and PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with N2O inhalation, TCI of propofol - remifentanil and intermittent i.v. boluses of vecuronium. Propofol -remifentanil target concentrations were titrated against AAIs value below 20 during maintenance of anesthesia. At the end of operation quality of anesthesia was evaluated. The total amount of propofol and remifentanil consumed were recorded. Aldrate post anesthetic recovery score and postoperative pain score were also assessed. Results TLOC was significantly shorter in group E [(0.45 ?0.1) min] than that in group P (0.86 ? 0.3 min) ( P
