Department of Anaesthesiology, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania.
Department of Surgery, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania.
Medicina (Kaunas). 2021 Oct 16;57(10):1114. doi: 10.3390/medicina57101114.
: Early postoperative recovery after surgery is a key point for patients' safety and comfort. Moreover, operating room turnover depends on recovery time. Our aim was to assess which method of remifentanil administration, manual (MI) or target-controlled infusion (TCI), could reduce patient time in recovery room. In this study, patients' recovery times were registered and compared among the groups. : We enrolled 31 morbidly obese patients in this prospective study. All of them had undergone bariatric surgery at the Hospital of Lithuanian University of Health Sciences Kauno Klinikos in 2020. Sevoflurane/remifentanil anaesthesia was performed for all patients. The patients were randomly assigned to the manual infusion (MI) (control group) or target-controlled infusion (TCI) group for the method of the administration of remifentanil. While the patients were waking up after the surgery, we recorded spontaneous breathing and airway reflexes recovery time, time of extubation, eye opening, recovery of orientation and beginning of the following oral command. For the TCI group, we also documented remifentanil concentrations in the blood (automatic infusion pump). : Patients did not differ in demographic values and duration of remifentanil infusion. We found that remifentanil consumption in the TCI group was lower, = 0.02. Despite lower remifentanil consumption in the TCI group patients, they demonstrated longer total recovery time than the control group patiens: 14 (12-20) vs. 10 (6-16), = 0.001. : The study showed that, upon comparing the TCI method with MI, manual infusion produced better results in postoperative patient recovery. Additionally, higher doses of remifentanil were consumed using MI. In conclusion, the dosage recommended by highly qualified anaesthesiologists is favourable for morbidly obesity patients when compared to the TCI method.
术后早期恢复是患者安全和舒适的关键。此外，手术室的周转率取决于恢复时间。我们的目的是评估哪种瑞芬太尼给药方式，手动（MI）或靶控输注（TCI），可以减少患者在恢复室的时间。在这项研究中，我们记录了患者的恢复时间并进行了比较。
我们前瞻性地纳入了 2020 年在立陶宛健康科学大学考纳斯临床医院接受肥胖症手术的 31 例病态肥胖患者。所有患者均接受七氟醚/瑞芬太尼麻醉。患者被随机分配到手动输注（MI）（对照组）或靶控输注（TCI）组接受瑞芬太尼给药。当患者在手术后醒来时，我们记录了自主呼吸和气道反射恢复时间、拔管时间、睁眼时间、定向恢复和开始下一个口头指令的时间。对于 TCI 组，我们还记录了血液中的瑞芬太尼浓度（自动输注泵）。
患者的人口统计学值和瑞芬太尼输注时间无差异。我们发现 TCI 组的瑞芬太尼消耗量较低，= 0.02。尽管 TCI 组患者的瑞芬太尼消耗量较低，但他们的总恢复时间比对照组患者长：14（12-20）vs. 10（6-16），= 0.001。
该研究表明，与 MI 相比，TCI 方法在术后患者恢复方面产生了更好的结果。此外，MI 时消耗的瑞芬太尼剂量更高。总之，与 TCI 方法相比，高度合格的麻醉师推荐的剂量对病态肥胖患者有利。
