Anesth Pain Med.  2011 Oct;6(4):331-335.

A comparison of the recovery characteristics of propofol-remifentanil and desflurane-remifentanil anesthesia under bispectral index (BIS) monitoring following laparoscopic cholecystectomy

• Kim YS
• Lee WK
• Choi YS
• Chae YK
• Ahn SW
• Lee A
• Yoon JW
• Lee YK

Abstract

BACKGROUND
The aim of this prospective, double-blind randomized study was to compare the recovery characteristics of desflurane-remifentanil and propofol-remifentanil anesthesia in patients undergoing a laparoscopic cholecystectomy under BIS monitoring.
METHODS
Eight patients (ASA I-II, 20-65 yr) undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol-remifentanil anaesthesia or desflurane-remifentanil. The BIS was monitored and maintained between 45-55. At the end of surgery all anesthetics were discontinued. Time to eye opening and time to extubation was recorded. Subsequently, the patients were transported to the post-anesthetic care unit (PACU) and the modified aldrete score, visual analogue scale (VAS), blood pressure, heart rate, and postoperative nausea and vomiting (PONV) were recorded upon arrival at the PACU, as well as at 15 min, 30 min, 1 hr, 2 hr, and 24 hr.
RESULTS
There were no significant differences in the incidence of PONV between the two groups. Modified aldrete scores were significantly higher in the propofol group at 15 min postoperative period (P = 0.013, Propofol = 9.87, Desflurane = 9.62). Further, VAS scores were significantly higher in the desflurane group at 30 min (P = 0.037, Propofol = 4.26, Desflurane = 5.0), and the number of antiemetic injections were significantly higher in the desflurane group at arrival to the PACU (P = 0.035, Propofol = 0, Desflurane = 0.11 +/- 0.052) and at 24 hr (P = 0.03, Propofol = 0.41 +/- 0.562, Desfluarane = 0.62 +/- 0.157).
CONCLUSIONS
In patients undergoing laparoscopic cholecystectomy with BIS monitoring, there is no significant differences in the incidence of PONV. The use of propofol is associated with less postoperative pain.

Keyword

Anesthesia recovery period; Bispectral index monitor; Desflurane; Laparoscopic cholecystectomy; Propofol; Remifentanil

MeSH Terms

Anesthesia
Anesthesia Recovery Period
Anesthetics
Blood Pressure
Cholecystectomy, Laparoscopic
Consciousness Monitors
Eye
Heart Rate
Humans
Incidence
Isoflurane
Pain, Postoperative
Piperidines
Postoperative Nausea and Vomiting
Postoperative Period
Propofol
Prospective Studies
Anesthetics
Isoflurane
Piperidines
Propofol