Abstract: The effect of remifentanil given by Target-Controlled Infusion (TCI) on rocuronium-induced neuromuscular (N-M) block during Total Intravenous Anesthesia (TIVA) is investigated. Sixty ASA I or II patients aged 25~55 years undergoing elective laparoscopic cholecystectomy under TIVA were randomly divided into 4 groups (n=15 for each group): group A propofol; group B propofol + (the target plasma concentration of) 2 ng/mL remifentanil; group C propofol + 4 ng/mL remifentanil; group D propofol + 6 ng/mL remifentanil. Propofol was delivered by TCI at the target plasma concentration of 3 ?滋g/mL during introduction of anesthesia, and was adjusted according to BIS maintained between 40 and 60 during surgery. Rocuronium 0.6 mg/kg was given intravenous. to facilitate tracheal intubation. N-M function was monitored and recorded using acceleromyography (TOF-GUARD, Organon Teknika B.V.). The force of thrum adduction in response to single and TOF stimulation of ulnar nerve was recorded. The onset time of N-M block was compared among the four groups ranging from 54 to 57 seconds. The duration of N-M block, the 75% recovery time and the recovery indexes among groups saw no significant difference. The results show that TCI different concentration of remifentanil has no synergistic effect on rocuronium induced N-M block. It is suggested that the mechanism of remifentanil reducing the requirements of rocuronium in total intravenous anesthesia is due to the effect on CNS.
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Received: 28 July 2009
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