Target-Controlled Infusion of Remifentanil for Plastic Surgery

 

Dong Hee Kim, M.D.

Department of Anesthesiology, College of Medicine, Dankook University, Cheon An, Korea

 

Background:

 This study was designed to evaluate the change of hemodynamics and reaction of intubation and surgical stimuli, analgesic effectives and side effects of target-controlled infusion (TCI) of remifentanil combined with propofol TCI in patients undergoing plastic surgery.

 

Methods:

 120 patients undergoing plastic surgery were randomly allocated to receive remifentanil TCI with target concentration (Tc) 1, 2, 3, 4, 5, 6 ng/ml (n=20, in each groups) with propofol at rates varied up and down depending on the bispectral index (BIS). The mean Tc of propofol according to change of concentration of remifentanil were determined. Induction and recovery time, responses in induction and surgical stimuli, mean BIS, and side effects were compared.

 

Results:

Recovery time was shortened in 4, 5, 6 ng/ml group (16.3, 13.1, 11.5 min) compared with other groups (28.1, 25.3, 22.1 min) (p<0.05). The mean Tc of propofol were significantly lower in 4, 5, 6 ng/ml group (3.8, 3.0, 2.8 ug/ml) than other groups (5.2, 4.8, 4.5 ug/ml) (p<0.05). Incidence of hypotension were significantly higher in 4, 5, 6 ng/ml groups (20, 25, 35%) than other groups (10, 5, 10%).

 

Conclusions:

 The optimal blood remifentanil and propofol concentration, with respect to satisfactory intraoperative anesthestic conditions and speed of recovery, are 4 ng/ml and 3.8 ug/ml or 5 ng/ml and 3.0 ug/ml or 6 ng/ml and 2.8 ug/ml in plastic surgery.