Clinical observation on remifentanil and propofol target-controlled infusion of intravenous anesthesia and anesthesia with sevoflurane on laparoscopically operations of gynecology

Objective To evaluate the clinical feasibility of the laparoscopically operations of gynecology(LA) through remifentanil and propofol target-controlled infusion of intravenous anesthesia and compare to anesthesia with sevoflurane,in order to search for a more rational style of anesthesia.Method Total 80 patients with ASA Ⅰ ~ Ⅱ,electived LA were randomly divided into two groups.Group A(TCI group):Setting the target plasma concentration of remifentanil 4 ng/ml,propofol 3 μg/ml;group B:continuously exposed to 2.5%~3.5% sevoflurane to maintain the LA.The average arterial pressure(MAP) and heart rate for tracheal intubation and extubation were observed;The time of withdrawal end of surgery to recovery of spontaneous breathing and consciousness recovery and extubation were observed;The visual analogue pain score(VAS) 30 min after operation and postoperative nausea and vomiting,the incidence of intraoperative awareness situation were observed.Results MAP and HR of group A at each observed point were significantly lower than the baseline values and that of group B(P0.05),MAP and HR of group B at the observed points were significantly higher than the baseline values(P0.05);recovery of spontaneous breathing and consciousness recovery and extubation of group A and group B had no significant difference(P0.05);from comparison of the visual analog pain score(VAS) 30 min after operation,group A was significantly better than group B(P0.05).Six patients of group A had nausea and vomiting,1 case of group A had intraoperative awareness.Conclusion Anesthesia style in group A is better,with fewer complications.