Target-controlled infusions of remifentanil and propofol during laparoscopic cholecystectomy



We have had this study to evaluate the clinical profile of target-controlled infusion-based anesthesia using remifentanil and propofol. 116 ASA I-II patients undergoing elective laparoscopic cholecystectomy (LCH) were enrolled. TCI Remifentanil was set at 8 micrograms. L - 1 as target and TCI propofol at 4 mcg/ml throughout the whole procedure. The hemodynamics during induction of anesthesia and recovery profiles were recorded. Arterial blood samples for analysis of remifentanil were taken 15 min after infusion, 20 min after infusion and at time of emergence. After induction of anesthesia, systolic blood pressure (SBP) decreased from (140 ± 24) mm Hg to (101 ± 16) mm Hg (P < 0.05), mean blood pressure (MBP) decreased from (103 ± 14) mm Hg to (75 ± 11) mm Hg (P < 0.05) and heart rate (HR) decreased from (78 ± 14) beats.min-1 to (65 ± 10) beats.min-1 (P > 0.05). SBP, MBP and HR remained stable after intubations for 3 min. No patient showed haemodynamic stress to tracheal intubations. Times from stopping administration of anesthetics until full spontaneous respiration, eye opening, tracheal extubation, orientation and discharging from the postanesthetic care unit (PACU) were (10±6), (7±4), (11±6), (12±5) and (18±7) min respectively. Measured drug values of remifentanil were (4.5±7.5) microgram. L-1, (6.4±11.4) microgram. L-1, (1.1±7.6) and microgram. L-1 respectively. Remifentanil/propofol TCI-based anesthesia achieved the optimal hemodynamic stability during anesthesia induction and maintenance, and better recovery profile from anesthesia. Measured drug values of remifentanil showed a considerable inter individual variation and more lower than the set target.