Effects of target-controlled infusion of remifentanil combined propofol on hemodynamics in patients undergoing pulmonary lobectomy

Objective To observe the effects of two target plasma concentrations of remifentanil combined with propofol TCI on hemodynamics in patients of thoracic surgery.Methods Forty ASA class Ⅱ patients,undergoing pulmonary lobectomy,were randomly divided into 2 groups with 20 cases each.The target plasma concentration of remifentanil was 6ng/ml in group R6 and 8ng/ml in group R8.Anesthesia was induced with remifentanil and propofol given by TCI. The plasma target concentration of propofol was set at 3μg/ml.After TCI of remifentanil alone began for 3min,propofol was given by TCI.MAP,HR,CO,SV,ACC,PV,TSVR and BIS were recorded before anesthesia(T0) during skin incision(T1),ribs breakdown(T2),chest exploration(T3),chest closion(T4),and skin sature(T5).Results Hemodynamic variables during operation were significantly changed more in group R8 than those in group R6.MAP,HR and TSVR were significantly increased more in group R6 than those in group R8 at T3 (P0.05).BIS values were significantly decreased during operation (P0.05),BIS values were insignificantly lower in group R8 than those in group R6 at T2 and T3. Conclusion On the basis of propofol 3μg/ml infusion,TCI 6ng/ml of remifentanil should be used at the beginning,and 8ng/ml be given during stronger surgical procedure to obtain fairly satisfactory anaesthesia effect.