Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Remifentanil-Propofol Sedation as an Ambulatory Anesthesia for Carpal Tunnel Release

  • Lee, Jae-Jun (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Hwang, Sung-Mi (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Jang, Ji-Su (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Lim, So-Young (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Heo, Dong-Hwa (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University) ;
  • Cho, Yong-Jun (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University)
  • Received : 2010.06.04
  • Accepted : 2010.11.25
  • Published : 2010.11.28
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Abstract

Objective : This prospective study evaluated the use of continuous sedation using propofol and remifentanil when carpal tunnel release (CTR) was performed under local anesthesia. Methods : We sedated 60 patients undergoing CTR using local anesthesia with remifentanil at loading and continuous doses of $0.5\;{\mu}g\;kg^{-1}$ and $0.05\;{\mu}g\;kg^{-1}min^{-1}$, respectively, and propofol, using a target controlled infusion (TCI) pump set to a target of $2\;{\mu}g\;mL^{-1}$ (group A), or with the same drug doses except that the continuous remifentanil dose was $0.07\;{\mu}g\;kg^{-1}min^{-1}$ (group B) or $0.1\;{\mu}g\;kg^{-1}min^{-1}$ (group C). Results : In group B, the levels of pain when local anesthetics were administered (p = 0.001), intraoperative pain (p < 0.001) and anxiety (p = 0.001) were significantly lower than those of group A. Furthermore, the incidence of adverse events, including desaturation (p < 0.001) and vomiting (p = 0.043), was significantly lower in group B than in group C. Conclusion : Continuous sedation using an appropriate dose of remifentanil and propofol can be used as safe, efficacious ambulatory anesthesia in cases of CTR under local anesthesia, performed using only 2 mL of local anesthetic, with a high degree of patient satisfaction.

Keywords

References

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