Kim Seong-Hyop, Oh Chung-Sik, Yoon Tae-Gyoon, Cho Min Jeng, Yang Jung-Hyun, Yi Hye Ran
Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea ; Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
ScientificWorldJournal. 2014;2014:724753. doi: 10.1155/2014/724753. Epub 2014 Jun 3.
The study was designed to investigate postoperative nausea and vomiting (PONV) in low- and high-dose remifentanil regimens for total intravenous anaesthesia (TIVA) in adult female patients with American Society of Anaesthesiologists physical status classification I undergoing local breast excision. Propofol and remifentanil 5 ng · mL(-1) (L group) or 10 ng · mL(-1) (H group) were administered for anaesthesia induction and maintenance. Propofol was titrated within range of 0.1 μg · mL(-1) to maintain bispectral index (BIS) values between 40 and 60. Haemodynamic parameters during the intra- and postoperative periods and 24 h postoperative visual analogue scale (VAS) and PONV were evaluated. Each group with 63 patients was analyzed. The H group showed higher use of remifentanil and lower use of propofol, with similar recovery time. Mean systemic arterial blood pressure (MBP), heart rate, and BIS did not differ significantly before and after endotracheal intubation in the H group. However, significant increases in MBP and BIS were apparent in the L group. Postoperative VAS, PONV incidence and scale, and Rhodes index did not differ significantly between the two groups. In conclusion, TIVA with high-dose remifentanil did not aggravate PONV with similar postoperative pain, compared with low-dose remifentanil. Furthermore, high-dose remifentanil showed more haemodynamic stability after endotracheal intubation. This trial is registered with KCT0000185.
本研究旨在调查接受局部乳房切除术的美国麻醉医师协会身体状况分级为I级的成年女性患者，在全凭静脉麻醉（TIVA）中使用低剂量和高剂量瑞芬太尼方案时的术后恶心和呕吐（PONV）情况。采用丙泊酚和5 ng·mL⁻¹瑞芬太尼（L组）或10 ng·mL⁻¹瑞芬太尼（H组）进行麻醉诱导和维持。丙泊酚在0.1 μg·mL⁻¹范围内滴定，以维持脑电双频指数（BIS）值在40至60之间。评估术中和术后的血流动力学参数以及术后24小时的视觉模拟评分（VAS）和PONV情况。对每组63例患者进行分析。H组瑞芬太尼用量较高，丙泊酚用量较低，恢复时间相似。H组气管插管前后平均体动脉血压（MBP）、心率和BIS无显著差异。然而，L组MBP和BIS明显升高。两组术后VAS、PONV发生率和分级以及罗兹指数无显著差异。总之，与低剂量瑞芬太尼相比，高剂量瑞芬太尼的TIVA在术后疼痛相似的情况下不会加重PONV。此外，高剂量瑞芬太尼在气管插管后显示出更高的血流动力学稳定性。本试验已在KCT0000185注册。
