Intravenous anesthesia


Anesthesia and Pain Medicine. 2005 Sept. 9(3): 98-106
ⓒ Korean Society for Intravenous Anesthesia
The Effects of the Target Concentration of Remifentanil on Propofol-Remifentanil Total Intravenous Anesthesia
Jong Hoon Nam, M.D., Jung Won Seo, M.D., Young Hoon Jeon, M.D., Chang Gu Han, M.D., and Si Oh Kim, M.D.
Department of Anesthesiology and Pain Medicine, College of Medicine, Kyungpook National University, Daegu, Korea

Background: Total intravenous anesthesia (TIVA) with remifentanil and propofol has many advantages such as no air pollution, no hepatic or renal toxicity and short, predictable duration of action. The goals of this study is to characterize the appropriate target plasma concentration of remifentanil combined with a target plasma concentration of propofol of 3mug/ml during anesthesia.
Methods: Sixty patients, aged 15 65 years and scheduled for orthopedic surgery were randomly allocated to four groups according to the target plasma concentrations of remifentanil of 1.5 ng/ml (R1.5), 2.0 ng/ml (R2.0), 2.5 ng/ml (R2.5) and 3.0 ng/ml (R3.0). All patients received a computer controlled infusion of propofol with a plasma concentration of 3mug/ml. Cardiovascular measurements and EEG bispectral index (BIS) were recorded. Also, we checked the dose requirements of ephedrine, atropine and remifentanil used to correct hypotension, bradycardia, hypertension and tachycardia.
Results: Patient characteristics and BIS values during anesthesia were similar among groups. There were no differences in recovery times between the groups. In Group R1 and R1.5, episodes of tachycardia were observed in intubation period and episodes of hypotension and bradycardia were observed in R3.0 group.
Conclusions: The appropriate target concentration of remifentanil combined with a target concentration of propofol of 3mug/ml during orthopedic surgery is 2.5 ng/ml.
Key words : propofol, remifentanil, total intravenous anesthesia
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