Recovery from propofol anaesthesia supplemented with remifentanil

We have examined the effects on recovery end-points of supplementation of a propofol-based anaesthetic with remifentanil. After induction of anaesthesia with propofol and remifentanil 1.0 μg kg−1, 15 patients each were randomly allocated to target plasma propofol concentrations of 2, 3, 4 or 5 μg ml...

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Bibliographic Details
Published in:	British journal of anaesthesia : BJA Vol. 86; no. 3; pp. 361 - 365
Main Authors:	O'Hare, R.A., Mirakhur, R.K., Reid, J.E., Breslin, D.S., Hayes, A
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-03-2001 Oxford University Press Oxford Publishing Limited (England)
Subjects:	Adolescent Adult anaesthesia i.v analgesics opioid, remifentanil Analgesics, Opioid - pharmacology Anesthesia Anesthesia Recovery Period Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics, Intravenous - administration & dosage Anesthetics, Intravenous - blood Anesthetics, Intravenous - pharmacology Biological and medical sciences Consciousness - drug effects Dose-Response Relationship, Drug Drug Interactions General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Humans Medical sciences Middle Aged pharmacodynamics Piperidines - pharmacology propofol Propofol - administration & dosage Propofol - blood Propofol - pharmacology Psychometrics Remifentanil propofol analgesics opioid, remifentanil pharmacodynamics anaesthesia i.v anaesthesia i.v., propofol; analgesics opioid, remifentanil; pharmacodynamics Human General anesthetic Awakening General anesthesia Opiates Propofol Narcotic analgesic Recovery Remifentanil
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Summary:	We have examined the effects on recovery end-points of supplementation of a propofol-based anaesthetic with remifentanil. After induction of anaesthesia with propofol and remifentanil 1.0 μg kg−1, 15 patients each were randomly allocated to target plasma propofol concentrations of 2, 3, 4 or 5 μg ml−1for maintenance of anaesthesia. Remifentanil was administered by infusion for supplementation in doses required for maintenance of adequate anaesthesia. All patients received 50% nitrous oxide in oxygen and ventilation was controlled. The total amount of drugs used and times to different recovery end-points were recorded. Cognitive function was also assessed using a Mini-Mental State questionnaire. The median dose of remifentanil for maintenance of adequate anaesthesia (excluding the initial bolus dose) in the four groups was 0.21, 0.15, 0.11 and 0.13 μg kg−1 min−1 respectively (P=0.0026). The median times to eye opening and orientation were shortest in the 2 μg ml−1 group [6.0 and 6.5 min, 8.5 and 10.8 min, 13.4 and 15.8 min, and 14.2 and 19.5 min respectively in the propofol 2, 3, 4, and 5 μg ml−1 groups respectively (P<0.001)]. The times to discharge from the recovery ward and the Mini-Mental State scores were not significantly different.
ISSN:	0007-0912 1471-6771
DOI:	10.1093/bja/86.3.361