Comparison of propofol alone and propofol plus remifentanil given by target-controlled infusion in analgesic artificial abortion

Objective: To compare the analgesic effects of target-controlled infusion(TCI) of propofol alone and propofol plus remifentanil in artificial abortion.Methods: Eighty cases of ASA-Ⅰ(American society of anesthesiologists,gradeⅠ),who were undergoing artificial abortion,were randomly divided into TCI propofol group(A) and TCI remifentanil-propofol group(B).Each group consisted of 40 cases.Group A were given only propofol,while Group B were given remifentanil at 2 μg/L plasma concentration first,and 3 minutes later,propofol was infused.The initial plasma concentration of propofol was set at 2.0 mg/kg and 1 minute later the concentration was added 0.5-1 mg/kg each time gradually until the patients lost consciousness.During the operation,the concentration of propofol was adjusted to reach the good state of anesthesia.Results: The anesthetic effect was significantly better in group B than in group A(P<0.005).The induction time was much shorter in group B than in group A(P<0.01),and the total amount of propofol used was much less in group B than in group A(P<0.01).Group A had more restlessness and hyperphasia during the reanimation stage than group B(P<0.005).Both groups had a postanesthetic drop in blood pressure,which was the most obvious at the time when the uterus was extended,and resumed to normal after operation(P<0.01).The patients' satisfaction degree showed no significant difference between the two groups(P>0.05),while the surgeon's satisfaction degree to group B was significantly higher than to group A(P<0.01).Conclusions: In painless artificial abortion,the TCI of propofol plus remifentanil is superior to that of propofol alone.The former shows a better anesthetic effect,a shorter induction time and a considerable reduction in propofol's dose and adverse reaction.It is a safe and reasonable vein anesthesia.