Application of low dose of propofol-remifentanil in elderly patients undergoing thoracic surgery

Objective To investigate the application of low dose of propofol-remifentanil in elderly patients undergoing thoracic surgery. Methods Eighty elderly patients(ASA Ⅰor Ⅱ) scheduled for elective thoracic surgery were randomly divided into two groups: group A with inhalational sevoflurane and group B with infusing propofol-remifentanil. All patients received epidural block. MAP, HR and BIS were recorded when entering the operating room(T0), anesthetic induction(T1), intubation(T2), beginning of operation(T3), 30 min after beginning of operation(T4), 60 min after beginning of operation(T5), 90 min after beginning of operation(T6) and extubation(T7). The recovery of independent respiration time, deglutation time, eye opening time upon calling, extubation time, the recovery of orientation force time after the drug withdrawal were recorded. Consciousness and restlessness of extubation were observed. Awareness of after operation was followed up. Results There was no significant difference in MAP, HR and BIS between group A and group B except for the time of extubation(P<0.05). Compared with group A, the recovery of independent respiration time, deglutation time, eye opening time upon calling, extubation time, the recovery of orientation force time and leaving the operating room time after the drug withdrawal significantly decreased in group B(P<0.05). Consciousness and restlessness of extubation were significantly better in group B than that in group A(P<0.05). All patients had no awareness. Conclusions Combined with epidural block, remifentanil infused at a rate of 0.05-0.10 μg/(kg·h) and propofol infused at a rate of 3 mg/(kg·h) for total intravenous anesthesia is safe and efficacious in elderly patients undergoing thoracic surgery. Key words: Remifentanil; Propofol; Elderly patients; Thoracic surgery