Effect of Remifentanil Concentration on Propofol Demand during Total Intravenous Anesthesia

Young Jun Kim, J. Song
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Abstract

Objective: The purpose of this study was to investigate the effects of remifentanil concentration during total intravenous anesthesia changes on propofol requirements, vital signs, wake-up time, and postoperative pain.Methods: After induction of anesthesia, the concentration of remifentanil was divided into 2 ng/mL (R2 group) and 6 ng/mL (R6 group). In each group, the propofol concentration for maintaining a bispectral index (BIS) of 40–50, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, time from drug discontinuation to eye opening, and pain score in the recovery room were all measured using the Student t-test. Differences between the two groups were verified for statistical significance.Results: The average BIS scores maintained during the time of measurement were 45.0±3.8 and 45.5±3.9 in the R2 and R6 groups, respectively. The effective concentrations of propofol to maintain these corresponding BIS scores were 3.0±0.6 mcg/mL and 2.4±0.7 mcg/mL in the R2 and R6 groups, respectively.Conclusion: On using propofol and remifentanil during total intravenous anesthesia, the R6 group showed a reduction in the amount of propofol required to maintain a constant BIS, as well as reduced intraoperative blood pressure and pulse compared to those in the R2 group. No significant effects were observed in the time taken for the patient to wake up postoperatively and in postoperative pain experienced by the patient.
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瑞芬太尼浓度对全静脉麻醉中异丙酚需求的影响
目的:探讨静脉全麻醉时瑞芬太尼浓度变化对异丙酚需氧量、生命体征、苏醒时间及术后疼痛的影响。方法:麻醉诱导后,瑞芬太尼浓度分为2 ng/mL (R2组)和6 ng/mL (R6组)。各组患者维持双谱指数(BIS) 40-50的异丙酚浓度、收缩压、舒张压、平均动脉压、心率、停药至睁眼时间、康复室疼痛评分均采用学生t检验。两组间的差异经统计学意义验证。结果:R2组和R6组在测量期间的BIS平均评分分别为45.0±3.8分和45.5±3.9分。在R2组和R6组,维持相应BIS评分的异丙酚有效浓度分别为3.0±0.6 mcg/mL和2.4±0.7 mcg/mL。结论:与R2组相比,R6组在全静脉麻醉中使用异丙酚和瑞芬太尼时,维持恒定BIS所需的异丙酚量减少,术中血压和脉搏也降低。在患者术后醒来所需的时间和患者术后经历的疼痛方面没有观察到明显的影响。
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