Application of target-controlled infusion of propofol plus remifentanil infusion in endoscopic submucous dissection

Objective To observe the anesthetic effect of target-controlled infusion(TCI) of propofol plus remifentanil infusion in outpatients undergoing endoscopic submucous dissection. Methods Thirty-eight patients with physical status I ～ Ⅱscheduled for an elective endoscopic submucous dissection under general anesthesia were enrolled in this study.All patients were randomly divided into two groups,group A(n=19)and group B(n=19).In group A,the patients received a target-controlled infusion(TCI) of propofol with the initial plama concentration of 3.0μg/ml,and then the dose was titrated upward or downward by 0.1μg/ml according to the anesthesia depth.In group B,the patients received a bolus dose of remifentanil 1μg/kg intravenous injection,followed with an infusion rate of 0.1μgokg-1omin-1 by micro-pump plus target-controlled infusion(TCI) of propofol with the initial plasma concentration of 2.5μg/ml,and then the dose was titrated upward or downward by 0.1μg/ml according to the anesthesia depth.Heart rate(HR),mean arterial blood pressure(MAP),pulse oxygen saturation(SpO2),the consumption of propofol,recovery time and the incidence rate of side effects were recorded.Results In both groups,MAP decreased 2 minutes after the induction of anesthesia and 2 minutes after the entry of gastroscpe compared to the preanesthesia period(P0.05).In both groups,HR decreased and SpO2 fell to a certain extent 2 minutes after the induction of anesthesia(P0.01),but the change was transient,and it attenuated 2 minutes after the entry of gastroscope(P0.05).None of the patients in both groups developed severe bradycadia or respiratory suppression.At any time point,the difference of the vital signs between two groups was of no statistical significance(P0.05).The difference of the overall intraoperative side effects between two groups was of no statistical significance(P0.05),the operation time between two groups was of no statistical significance(P0.05).The recovery time was much shorter and the consumption of propofol during the anesthesia was smaller for the patients in group B(P0.01).Conclusions It is effective and safe to use target-controlled infusion(TCI) of propofol plus remifentanil infusion in outpatients undergoing endoscopic submucous dissection.Compared to single propofol infusion,patients receiving target-controlled infusion(TCI) of propofol plus remifentanil infusion recovered faster.