Evaluation of Recovery and Anesthetic Gas Consumption Using Remifentanil Combined with Low-Flow Sevoflurane Anesthesia in Tympanoplasty

Abstract

Background: The aim of this study was to compare the effects of low-flow sevoflurane and low-flow sevoflurane supplemented with remifentanil anesthesia on the recovery time, consumption amount of the anesthetic drugs and hemodynamic differences. Materials and Methods: A prospective, randomized and double-blinded study with 50 patients was designed. Following intubation, group S received sevoflurane 1.8 vol%, oxygen, nitrous oxide at 4 l · min^–1 and normal saline continuous infusion; group SR received sevoflurane 1.2 vol%, oxygen, nitrous oxide at 4 l · min^–1 and 0.25 µg · kg^–1 · min^–1 remifentanil continuous infusions. Ten minutes after intubation the flow rates decreased to 1 l · min^–1. Consumption of each drug, postoperative recovery characteristics and visual analog scale (VAS) scores for pain were recorded. Result: There were no significant differences in hemodynamic parameters, tramadol consumption and VAS scores for pain. The patients in group SR showed faster early recovery as compared to group S. The mean consumption of sevoflurane was 18 ml in group SR, while it was 25 ml in group S. Conclusions: Low-flow sevoflurane anesthesia combined with remifentanil regimen in patients undergoing tympanoplasty surgery resulted in a faster early recovery and decreased sevoflurane consumption.

Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

“…Similarly, Kim et al [7] in a study of 40 females undergoing gynecological surgery with entropy monitored general anesthesia, demonstrated that the end-tidal sevoflurane concentration as well as the total volatile gas consumption had been reduced by continuous intraoperative remifentanil infusion. We agree with those authors [7,36] in the context that reducing the consumption of the inhalational anesthetics without compromising both the clinical outcome and the patient satisfaction is highly desirable in order to facilitate earlier recovery from general anesthesia and to minimize the environmental pollution and the economic waste. In the present study, we used the spectral entropy monitoring to titrate the sevoflurane concentration to the desirable depth of anesthesia.…”

“…Sert and his colleagues [36] concluded that the use of low flow sevoflurane anesthesia combined with continuous intraoperative remifentanil infusion during tympanoplasty resulted in a faster early recovery and decreased sevoflurane consumption. Similarly, Kim et al [7] in a study of 40 females undergoing gynecological surgery with entropy monitored general anesthesia, demonstrated that the end-tidal sevoflurane concentration as well as the total volatile gas consumption had been reduced by continuous intraoperative remifentanil infusion.…”