title: Propofol/remifentanil vs sevoflurane/remifentanil for long lasting surgical procedures: a randomised controlled trial.
abstract: We compared the haemodynamics, emergence and recovery characteristics of total intravenous anaesthesia using propofol/remifentanil with sevoflurane/remifentanil anaesthesia, under bispectral index guidance, in 103 patients undergoing surgical procedures lasting > 3.5 h. Time to tracheal extubation was significantly shorter in the propofol group than in the sevoflurane group (mean (SD) 8.3 (3.5) min vs 10.8 (4.6) min, respectively; p = 0.0024), but further recovery was comparable in both groups. There were no significant differences in haemodynamic parameters, intensity of pain or postoperative nausea and vomiting. During and after anaesthesia of comparable depth for long lasting surgical procedures, both propofol/remifentanil and sevoflurane/remifentanil enable haemodynamic stability and fast emergence. The shorter time to extubation in the propofol group does not offer a relevant clinical advantage.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105, Kiel, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Höcker
authors.forename: P H
authors.initials: PH
authors.lastname: Tonner
authors.forename: P
authors.initials: P
authors.lastname: Böllert
authors.forename: A
authors.initials: A
authors.lastname: Paris
authors.forename: J
authors.initials: J
authors.lastname: Scholz
authors.forename: C
authors.initials: C
authors.lastname: Meier-Paika
authors.forename: B
authors.initials: B
authors.lastname: Bein
mesh_terms: D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003071:Cognition / Q000187:drug effects; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D010149:Postoperative Pain; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D000077149:Sevoflurane; D013520:Urologic Surgical Procedures
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol