Remifentanil-propofol sedation as an ambulatory anesthesia for carpal tunnel release

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 μg kg-1 and 0.05 μg kg-1min-1, respectively, and propofol, using a target controlled infusion (TCI) pump set to a target of 2 μg mL-1 (group A), or with the same drug doses except that the continuous remifentanil dose was 0.07 μg kg-1min-1 (group B) or 0.1 μg kg-1min-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. © 2010 The Korean Neurosurgical Society.