Effects of different plasma target concentrations of remifentanil on the MACBAR of sevoflurane in children with laparoscopic surgery

Background: To investigate the effects of different plasma target concentrations of remifentanil on the minimum alveolar concentration (MAC) for blocking adrenergic response (BAR) of sevoflurane in children with laparoscopic herniorrhaphy. Methods: Seventy-five children with 3-7 years old scheduled for laparoscopic herniorrhaphy were randomly divided into group R-0, group R-1,R- and group R-2 according to different remifentanil plasma target concentration (0, 1, and 2 ngml(-1)), respectively. The MAC(BAR) of sevoflurane was determined by the up-and-down and sequential method in each group. The concentrations of epinephrine and noradrenaline were also determined at corresponding time points. Results: A total of 52 child patients were used among the anticipated 75 patients. In groups R-0, R-1,R- and R-2, the MAC(BAR) of sevoflurane was (3.29 +/- 0.17) %, (2.12 +/- 0.10) % and (1.29 +/- 0.11) %, respectively, and a significant difference was found among the three groups (P<0.05). The changes of epinephrine and noradrenaline concentrations in each group before and after insufflation of carbon dioxide pneumoperitoneum showed no significant differences. Conclusion: Remifentanil by target-controlled infusion can effectively reduce the MAC(BAR) of sevoflurane during laparoscopic surgery in children. At a similar effect of MAC(BAR), both the changes of epinephrine and noradrenaline concentrations are not affected by the infusion of different remifentanil target concentrations.

Automated summary

The study findings suggest that target-controlled infusion of remifentanil can effectively reduce the MAC(BAR) of sevoflurane during laparoscopic surgery in children. The infusion of different remifentanil target concentrations does not significantly affect the changes in epinephrine and noradrenaline concentrations at a similar level of MAC(BAR) effect.