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A Comparison of the Recovery Characteristics between Propofol-remifentil and Sevoflurane-remifentail Anesthesia for Total Thyroidectomy

Article information

Kosin Med J. 2013;28(2):137-143
Publication date (electronic) : 2013 January 19
doi : https://doi.org/10.7180/kmj.2013.28.2.137
Dong Hee Kang, Jeong Gil Lee, Hyeong Ju Jung, Ju Deok Kim, Soo Bong Yu, Si Jeong Ryu, Gyeong Han Kim, Doo Sik Kim
Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University, Busan, Korea
Corresponding author: Doo Sik Kim, Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University, 34 Amnam-dong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6627 FAX: +82-51-254-2504 E-mail: kds0728@chol.com
Received 2013 March 12; 2013 May 16; Accepted 2013 June 26.

Abstract

Objectives

This study was investigated the recovery characteristics of propofol-remifentanil and sevoflurane-remifentanil anesthesia for total thyroidectomy

Methods

Eighty patients in ASA physical status 1 and 2 scheduled for total thyroidectomy were allocated randomly to either group P (n = 40) or group S (n = 40). Anesthesia was maintained with remifentanil effect site concentration (Ce) 1-3 ng/mL and propofol Ce 2-4 μ g/mL in the group P, and was maintained with remifentanil Ce 1-3 ng/mL and sevoflurane 1.5-2% in the group S. Blood pressure, heart rate, and bispectral (BIS) index were measured during perioperative period. The times from discontinuance of anesthetic agent to eye opening, to extubation, and to stating name were measured. Postoperative complications were evaluated.

Objectives

This study was investigated the recovery characteristics of propofol-remifentanil and sevoflurane-remifentanil anesthesia for total thyroidectomy

Methods

Eighty patients in ASA physical status 1 and 2 scheduled for total thyroidectomy were allocated randomly to either group P (n = 40) or group S (n = 40). Anesthesia was maintained with remifentanil effect site concentration (Ce) 1-3 ng/mL and propofol Ce 2-4 μ g/mL in the group P, and was maintained with remifentanil Ce 1-3 ng/mL and sevoflurane 1.5-2% in the group S. Blood pressure, heart rate, and bispectral (BIS) index were measured during perioperative period. The times from discontinuance of anesthetic agent to eye opening, to extubation, and to stating name were measured. Postoperative complications were evaluated.

Results

There were no significant differences between group P and S on the blood pressure, heart rate, and recovery time. BIS index of group P showed lower than that of group S during operation (P < 0.05). The incidences of side effects were similar in the two groups, though the incidence of nausea was higher in the group S (P < 0.05).

Conclusions

Propofol-remifentanil anesthesia was more advantageous than sevoflurane-remifentanil anesthesia for thyroidectomy in view of side effect incidences.

Keywords: Propofol; Remifentanil; Sevoflurane; Total thyroidectomy
Fig. 1.

Perioperative changes of mean arterial pressure (MAP). T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation; T6, postanesthetic care unit (PACU). Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.465).

Fig. 2.

Perioperative changes of heart rate (HR). T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation; T6, postanesthetic care unit (PACU). Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.691).

Fig. 3.

Perioperative change of bispectral (BIS) index. T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation. Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.001).

Characteristics of patients

times from discontinuance of anesthetic drug

Emergence complications of postoperative period

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Copyright © 2013 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1.

Fig. 1.

Perioperative changes of mean arterial pressure (MAP). T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation; T6, postanesthetic care unit (PACU). Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.465).

Fig. 2.

Fig. 2.

Perioperative changes of heart rate (HR). T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation; T6, postanesthetic care unit (PACU). Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.691).

Fig. 3.

Fig. 3.

Perioperative change of bispectral (BIS) index. T0, 2 minutes before the induction; T1, right before the endotracheal intubation; T2, right after the endotracheal intubation; T3, right before the beginning of operation; T4, right after the beginning of operation; T5, right before the extubation. Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. Each data was shown as mean ± SD (between groups: P = 0.001).

Table 1.

Characteristics of patients

Group P (n = 40) Group S (n = 40)
Age (yr) 039.2 ± 8.2 041.5 ± 7.5
Sex (M/F) 0005/35 0007/33
Height (cm) 163.7 ± 6.5 161.4 ± 6.7
Weight (kg) 060.6 ± 5.5 057.9 ± 7.2
Duration of anesthesia (min) 143.7 ± 23.5 155.1 ± 19.8

Values are mean ± SD.

Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. There were no differences between two groups.

Table 2.　Emergence

times from discontinuance of anesthetic drug

Group P (n = 40) Group S (n = 40)
Time to eye opening (min) 11.2 ± 2.7 10.4 ± 1.9
Time to extubation (min) 11.9 ± 2.4 11.1 ± 1.9
Time to stating name (min) 14.1 ± 2.2 14.5 ± 2.4

Each data was shown as mean ± SD.

Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. There were no differences between two groups.

Table 3.

Emergence complications of postoperative period

Group P Group S
(n = 40) (n = 40)
Coughing 0 (0%) 4 (10%)
Nausea and Vomiting 3 (7.5%) 13 (32.5%)*
Nausea only 3 (7.5%) 10 (25%)*
Nausea with vomiting 0 (0%) 3 (7.5%)
Breath holding 0 (0%) 0 (0%)
Shivering 1 (2.5%) 0 (0%)

Number (%). Group P, propofol and remifentanil; Group S, sevoflurane and remifentanil. *P < 0.05.