Target-Controlled Infusion of Remifentanil Without Muscle Relaxants Allows Acceptable Surgical Conditions During Thoracotomy Performed Under Sevoflurane Anesthesia.

摘要: Objectives: To test the hypothesis that use of a nonmuscle relaxant anesthetic technique (NMRT) during thoracotomy would be associated with comparable surgical conditions standard neuromuscular blocking drugs. Design: A prospective, randomized, single-blind, controlled study. Setting: single university hospital. Participants: Sixty-six patients scheduled for open under sevoflurane anesthesia targetcontrolled infusion (TCI) remifentanil. Interventions: After ethical approval, were randomly assigned to receive cisatracurium or saline (n ¼ 33 each group) entire study period. Measurements and Main Results: The four-point ordinal rating scale, intubating conditions, anesthetics vasopressors, incidence light (defined as an episode state entropy values exceeded 50 and/or mean arterial blood pressure heart rate baseline by 20% lasted more than 3 consecutive minutes), times clinical recovery postanesthesia care unit (PACU) discharge, hospital stays, postoperative residual curarization (PORC) recorded. Compared cisatracurium, NMRT resulted in good-toexcellent scales (90.9% v 94.0%, respectively; p 0.642), good-to-excellent laryngoscopy endobronchial (93.9% 100%, 4 0.09), vasopressor medications, together shorter recovery, extubation (7.6 [95% CI 6.82 8.39] 19.0 15.76 22.23] minutes, o 0.001), PACU stays (37.4 35.09 39.79] 70.9 56.90 84.91] 0.001). nonstatistical number episodes upon positioning, skin incision, rib separation (p 0.624, Fisher’s exact test). There no failed intubations 2 groups. No patient received group. Two (6.1%) group experienced PORC required tracheal intubation PACU. Conclusion: TCI remifentanil offers acceptable laryngoscopy, intubating, thoracotomy, especially when. anesthesiologists have