Continuous Infusion of Alfentanil combined with Target-Controlled Infusion of Propofol for Plastic Surgery

Dong Hee Kim, M.D.

Department of Anesthesiology, College of Medicine, Dankook University, Cheon An, Korea

Background: The goals of this study were to determine the plasma concentration of propofol required to provide satisfactory anesthesia in the presence of nitrous oxide over a range of alfentanil infusion for analgesia and to determine the dosing rates required to achieve adequate anesthesia.

Methods: Sixty patients undergoing plastic surgery were anesthetized with alfentanil (0 (A0 group) or 5 µg/kg loading followed by 0.12 µg/kg/min (A5 group) or 10 µg/kg loading followed by 0.25 µg/kg/min (A10 group) or 20 µg/kg loading followed by 0.5 µg/kg/min (A20 group)) and propofol using target-controlled infusion. The mean target concentration and infusion rate of propofol, induction and recovery time according to change of alfentanil regimen were checked.

Results: Induction and recovery time were prolonged in A0 group than other groups and infusion rate and mean target concentration of propofol were significantly higher in A0 group than other groups (P < 0.05). Side effects did not differ among the groups.

Conclusion: The optimal blood propofol concentration and infusion rate of alfentanil, both with satisfactory intraoperative anesthetic conditions and speed of recovery, are 3.51 ㎍/ml and 0.12 µg/kg/min with 5 ㎍/kg loading or 3.02 ㎍/ml and 0.25 ㎍/kg with 10 ㎍/kg loading or 2.35 ㎍/ml and 0.5 ㎍/kg/min with 20 ㎍/kg loading in plastic surgery patients.