Anesthetics, Propofol, Remifentanil
Conditions
Keywords
propofol, remifentanil, total intravenous anesthesia, breast surgery
Brief summary
Co-administration of propofol and remifentanil is considered to be an ideal total intravenous anesthesia technique, which is widely used in induction and maintenance of general anesthesia. Remifentanil and propofol can be mixed in polypropylene syringes for one hour with a remaining concentration of 91% in small concentrations of remifentanil. However, delivery of remifentanil-propofol mixture by target-controlled infusion(TCI) for general anesthesia in surgical procedure has not been described. Breast cancer surgery ( including modified radical mastectomy and breast-conserving surgery) is a less time-consuming procedure for patients with breast cancer with one-hour duration in our hospital. This pilot study was to examine the merit of remifentanil-propofol mixture as a GA regimen for breast cancer surgery.
Detailed description
Previous studies has described the feasibility and safety of remifentanil-propofol mixture use in sedation of pediatric patients undergoing magnetic resonance imaging or flexible fiberoptic bronchoscopy.
Interventions
COMBINATION_PRODUCTRemifentanil-propofol mixture
Participants receive total intravenous anesthesia with remifentanil-propofol mixture by single TCI pump in intervention group. All TCI target concentration adjustments or extra bolus of propofol or remifentanil during operation were based on BIS and ANI monitor.
Sponsors
Tri-Service General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
84 patients scheduled for breast cancer surgery were randomly allocated to receive TIVA with propofol and remifentanil separately by two TCI pump (Separate group) or with remifentanil-propofol mixture by single TCI pump (Mix group), all TCI concentration adjustments during operation were based on BIS and ANI monitor.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ASA II or III * age more than 18 years * scheduled for breast cancer surgery under general anesthesia.
Exclusion criteria
* previously allergic to propofol or remifentanil * combining other surgical procedure leading to extended operative time
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of TCI device adjustments | during procedure | Total times of TCI pump adjustment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | at 5 minute intervals perioperatively throughout the procedure in an average of 60 minutes | recorded by ECG and pulse oximetry |
| Patient satisfaction | the 1 day after operation | Rating of satisfaction by questionnaire |
| Mean blood pressure | at 5 minute intervals perioperatively throughout the procedure in an average of 60 minutes | measured by non-invasive blood pressure cuff |
| Total dose of remifentanil | At the end of surgery | total consumption of remifentanil during procedure |
| Total dose of propofol | At the end of surgery | total consumption of propofol during procedure |
| postoperative analgesia rescue | An average of 30 minutes after arriving at PACU | Analgesics use during PACU stay |
Countries
Taiwan
Outcome results
None listed