Study on total intravenous anesthesia with target-controlled infusion of propofol and continuous intravenous infusion of remifentanil in pediatric short duration surgery

AIM:To evaluate the anesthetic effect and the safety of total intravenous anesthesia(TIVA) with target-controlled infusion of propofol and continuous intravenous infusion of remifentanil in pediatric short duration surgery:comparison with total inhalational anesthesia. METHODS:60 pediatric cases suffered from short duration elective surgery were randomly divided into two groups,30 cases each group.The intravenous group and inhalation group(control group).Patients in the intravenous group were anesthetized by TIVA with target controlled infusion of propofol(3 μg/mL) and remifentanil continuous intravenous infusion(0.2-0.3 μg·kg-1·min-1).Patients in the control group were given inhalation of 3%-4% sevoflurane.The heart rate(HR),mean arterial blood pressure(MAP) and spectral index(BIS) of the patients were recorded at time points:before induction(T0),after induction(T1),LMA insertion(T2),skin incision(T3),10 mins after skin incision(T4),LMA extraction(T5).Recording the awakening time,degree of vigilance(OAA/S scores) and postoperative adverse events.RESULTS:The HR and MAP of T2-T5 in control group were significantly higher than those in intravenous group(P0.05 or 0.01).There were significantly different of T1-T5 values of HR and MAP in control group(P0.05),but not in intravenous group(P0.05).The awakening time in intravenous group was significantly shorter than that in control group(P0.05).The OAA/S scores 10 mins after drug discontinuance were higher in intravenous group than those in control group(P0.05).The occurrences of postoperative nausea,vomiting and restlessness were more frequently observed in patients in the control group than those in intravenous group(P0.05).The anesthesia satisfactory ratio was higher in intravenous group than that in control group.CONCLUSION:TIVA with target-controlled infusion of profofol and continuous intravenous infusion of remifentanil displays stability in hemodynamics,less stress,rapid recovery,less complications,better clinical results in pediatric short duration surgery.