Korean J Anesthesiol.  2016 Apr;69(2):155-160. 10.4097/kjae.2016.69.2.155.

Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study

• Cho S
• Han JI
• Baik HJ
• Kim DY
• Chun EH

• KMID: 2242953
• DOI: http://doi.org/10.4097/kjae.2016.69.2.155

Abstract

BACKGROUND
The aim of this study was to determine the appropriate target concentrations at the effect site of propofol and remifentanil when deep sedation was achieved by monitored anesthesia care (MAC) anesthesia and related respiratory depression during vein stripping surgery for varicose veins.
METHODS
In total, 51 adult patients who were scheduled for varicose vein stripping surgery were sedated with propofol and remifentanil during the surgery, after administration of midazolam. Target concentrations at the effect site of the two drugs were changed based on the patient's status. Respiratory support was applied in the order of oxygen supply, chin lift, and assisted mask ventilation. Target concentrations at the effect site of propofol and remifentanil, the need for respiratory support, and a six-point rating scale satisfaction score were the outcome measurements.
RESULTS
Only one patient did not require oxygen, eight patients needed oxygen alone, 22 patients required use of the chin lift technique, and 20 patients were assisted with mask ventilation. There was no significant difference in the target concentration of propofol or remifentanil between the patients who required mask ventilation and those who did not. Fifty of the 51 patients reported a satisfaction score of 6.
CONCLUSIONS
Although MAC using low target concentrations of propofol and remifentanil during vein stripping surgery was satisfactory to patients, close observation regarding the need for respiratory assistance was necessary.

Keyword

Deep sedation; Propofol; Remifentanil; Respiration

MeSH Terms

Adult
Anesthesia*
Chin
Deep Sedation
Humans
Masks
Midazolam
Oxygen
Propofol*
Prospective Studies*
Respiration
Respiratory Insufficiency
Saphenous Vein*
Varicose Veins
Veins
Ventilation
Midazolam
Oxygen
Propofol