Comparison of clinical effects of two different infusion methods of anesthesia for thoracic surgery

Objective To compare the anesthesia effects of intravenous injection versus target controlled infusion( TCI) of remifentanil combined with propofol in patients under going thoracic surgery. Methods Forty patients undergoing thoracic surgery were enrolled in this study,and randomly divided into two groups: intravenous remifentanil combined with propofol group( IR group,n = 20),and TCI of remifentanil combined with propofol group( TR group,n = 20). In IR group,the patients were intramuscularly administrated with midazolam 0. 05 mg /kg and atropine 0. 5 mg /kg before anesthesia,and propofol 2. 5 mg /kg and remifentanil 4 μg /kg were injected intravenously at the beginning of induction. In TR group,anesthesia was induced with propofol 2. 5 mg /kg and TCI of remifentanil 6 ng /ml,but the doses of the other drugs were the same as those in IR group. Mean arterial blood pressure( MAP),heart rate( HR),surplus pulse O2( SpO2) and the bispectral index( BIS) were recorded and compared. Time of spontaneous breathing,eye opening,extubation,OAAS scored 5,intraoperative awareness and postoperative adverse reactions were compared between two groups. Results The circulation in TR group was relatively stable during the operation. Time of spontaneous breathing,eye opening,extubation and OAAS scored 5 in IR group was significantly longer than in TR group( P 0. 05). There was no significant difference in postoperative nausea and vomiting between two groups. Conclusion TCI of remifentanil combined with propofol can supply hemodynamic stability and maintain an effective depth of anesthesia.