Total intravenous anesthesia: propofol/remifentanil vs midazolam/remifentanil in thoracic surgery

Abstract

Introduction:Anesthesia administration techniques in thoracic surgery have undergone great evolution and greater scientific foundation. Total intravenous anesthesia based on analgesia favors the perioperative period without pain and recovery without complications.Objective:To compare the effectiveness and safety of two techniques of total intravenous anesthesia in elective thoracic surgery with remifentanil as an analgesic base.Methods:Prospective and causiexperimental study carried out at Dr. Salvador Allende Clinical-Surgical Teaching Hospital, in the period from January 2013 to January 2015, with 45 patients scheduled for elective thoracic surgery, who were divided into two groups according to the hypnotic drug used. Group A: propofol/remifentanil, and group B: midazolam/remifentanil. Hemodynamic variables were evaluated at different times during the intraoperative period. Oxygenation variables (PaO2 and SaO2) during unipulmonary ventilation and anesthetic recovery times.Results:Patients older than 60 years predominated in the two groups, with a physical status of ASA III. There were no differences in arterial oxygenation between the groups. There was a decrease in systolic blood pressure in group A without significant differences. The recovery of anesthesia was significantly more delayed in group B.Conclusions:The total intravenous anesthesia technique with remifentanil as an analgesic base associated with propofol was safe and effective in patients undergoing thoracic surgery.Keywords: intravenous total anesthesia; remifentanil; propofol; midazolam; elective thoracic surgery.