[Target-controlled infusions of remifentanil and propofol in elderly patients].
OBJECTIVE
To investigate the clinical reliability and feasibility of target-controlled infusion (TCI) with different plasma concentration remifentanil and propofol.


METHODS
Thirty ASA I-II patients, > or =65 years old, undergoing selective lower abdominal operation were divided into 3 groups, group A with anesthesia using propofol combined with epidural block, group B with anesthesia using propofol and remifentanil (plasma concentration 4 microg/L), group C with anesthesia using propofol and remifentanil (plasma concentration 7 microg/L). BIS value, heart rate, blood pressure, heart rate variability and so on, were recorded during anesthesia and operation. Radial arterial blood samples for analysis of plasma concentration of propofol were taken during operation.


RESULTS
(1) The intubation response of groups B and C was lower than that of group A . (2) The depth of anesthesia was enough during operation (BIS value=45-60). (3) TCI propofol combined with remifentanil didn't lengthen the awaking time of patients; (4) MDPE of target-controlled infusion using propofol with Marsh parameters was 11.17%, MDAPE was 12.16% in Chinese elderly patients.


CONCLUSIONS
Remifentanil with plasma concentration of 4 and 7 microg/L combined with propofol could be safely used during clinical anesthesia of old patient, but monitoring must be strengthened during induction when plasma concentration of remifentanil was 7 microg/L. TCI propofol with Marsh parameters could be applied to Chinese elderly patients safely and efficiently.
Xu
Chuan-ya
CY
Department of Anesthesiology, Peking University Third Hospital, Beijing 100083, China.
Wu
Xin-min
XM
Jiang
Jian-yu
JY
D000005:Abdomen / Q000601:surgery; D000368:Aged; D000771:Anesthesia, Intravenous / Q000379:methods; D019162:Anesthetics, Combined / Q000008:administration & dosage* / Q000493:pharmacokinetics; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000493:pharmacokinetics; D016503:Drug Delivery Systems / Q000379:methods; D004360:Drug Therapy, Computer-Assisted / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010880:Piperidines / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D015742:Propofol / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D000077208:Remifentanil; D015203:Reproducibility of Results
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol