Anesthesia Effect of Remifentanil Combined with Propofol for Elective Small and Medium-Sized Operations in Patients with Uncontrolled Hypertension

Jia Z, Liu X, Lei Z, Gao D, Yang Nand Lei E

Department of Anesthesiology, the First Affiliated Hospital of Nanchang University, Nanchang, China Department of Medicine, Graduate School, Nanchang University, Nanchang, China

^*Correspondance to: Enjun Lei 

 PDF  Full Text DOI: 10.25107/2474-1647.3658

Abstract

Objective: To observe the anesthetic effect of remifentanil and propofol in selective small and medium-sized operation for uncontrolled hypertension patients. Methods: From September 2021 to October 2022, 86 patients with uncontrolled hypertension were selected for elective small and medium-sized operations, including 2 patients with hypertension and coronary heart disease, 15 patients with hypertension and abnormal electrocardiogram, 3 patients with hypertension and diabetes, and 2 patients with hypertension and other systemic diseases. All of them planned to undergo elective small and medium operations (LC in 58 cases, colon cancer in 5 cases, thyroid surgery in 10 cases, intracranial glioma in 7 cases, and total hysterectomy in 6 cases). The operation time was 116 ± 80.6 min. Patients with ASA1-4 (66 patients with ASA1-2, 16 patients with ASA3, and 4 patients with ASA4) were aged 28 to 89 years and weighed 48 kg to 98 kg. Propofol 2~3 mg/kg, sufentanil 0.4~0.6 μg/kg, cisatracurium 0.15~0.2 mg/kg were induced intravenously, remifentanil (0.3~0.4 μg/kg/min) was pumped, atracurium (1~2 μg/kg/min) was pumped to maintain muscle relaxation. Target controlled infusion of propofol with effective chamber concentration of 2 μg/ml to 5 μg/ml, general anesthesia was performed to maintain the minimum effective concentration of sevoflurane combined with inhalation at 0.8 to 1.5 alveolar levels in all patients, and intermittent addition of cisatracurium with 2 mg to 4 mg to maintain appropriate muscle relaxations. SP, DP, HR, SpO2 were recorded before anesthesia, after induction (A), after tracheal intubation (B), during anesthesia (C), and before tracheal extubation (D). The number of cases of recovery within 5 min after the operation, severe hypertension, severe hypotension during anesthesia, and serious complications of hypertension after surgery were recorded. Results: The induction of anesthesia in this group was basically stable. After induction, the decrease of SP and HR was (36.3 ± 11.8%) and (26.9 ± 11.4%), respectively, which were significantly different from those before induction (P<0.01). SP and HR after tracheal intubation were significantly higher than those after induction (P<0.01), but there was no significant difference compared with those before induction (P>0.05). SP and HR decreased slightly during anesthesia, but there was no significant difference compared with those before induction (P>0.05). The levels of SP and HR before tracheal extubation were significantly higher than those before induction (P<0.01). All patients (100%) were fully awake within 5 min after the end of operation. There were 2 cases of severe hypertension and 1 case of severe hypotension during the operation. There were no cases of serious complications of hypertension after the operation. Conclusion: The application of remifentanil and propofol in the anesthesia of uncontrolled hypertension patients undergoing elective small and medium-sized operations has a definite effect, and the method is simple, safe and reliable.

Keywords

Remifentanil; Propofol; Uncontrolled hypertension

Cite the article

Jia Z, Liu X, Lei Z, Gao D, Yang N, Lei E. Anesthesia Effect of Remifentanil Combined with Propofol for Elective Small and Medium-Sized Operations in Patients with Uncontrolled Hypertension. Clin Surg. 2023; 8: 3658..