Target-controlled infusion of propofol combined with remifentanil or fentanyl: a comparison of anesthetic depth

Objective:To compare the anesthetic depth and postoperative recovery of propofol combined with remifentanil or fentanyl when administered through target-controlled infusion(TCI).Methods: Ninety patients receiving elective epigastric surgery were randomly divided into 3 groups: PF-A,PF-B and PR group.Through TCI,patients in PF-A group were administered with propofol(3 μg /ml) and fentanyl(2 μg/L),in PF-B group with propofol(3 μg/ml) and fentanyl(4 μg/L initially and 2 μg/L after intubation),and in PR group with propofol(3 μg/ml) and remifentanil(6 μg/L).Vital signs(including mean aortic pressure and heart rate) and bispectral index values were recorded pre-anesthesia,pre-and post-intubation,post-incision and during operation in 3 groups.Results: In PF-A group,post-intubation MAP and HR were significantly higher than those of pre-intubation(P0.05),with obvious stress response during intubation.Whereas there was no significant difference in all parameters between those pre-intubation and post-incision.The vital signs maintained stable during anesthesia and operation in PF-B and PR groups.There was no significant difference in BIS values between 3 groups.During recovery phase the awakening time of PR group was significantly shorter than those of PF-A and PF-B groups.Conclusion: Clinical administration of 4 μg/L fentanyl or 6 μg/L remifentanil can effectively suppress the hemodynamic response to tracheal intubation and incision in propofol TCI anesthesia.However,2 μg/L fentanyl is only enough to suppress the response to incision but not to intubation.