[Propofol and remifentanil in day surgery]

Area of Science:

• Anesthesiology
• Pharmacology
• Day Surgery

Background:

• Propofol and remifentanil are commonly used anesthetic agents in day surgery settings.
• Comparing general anesthesia (AG) with monitored anesthesia care (MAC) is crucial for optimizing patient recovery and resource utilization.

Purpose of the Study:

• To compare general anesthesia (AG) versus monitored anesthesia care (MAC) using propofol and remifentanil in a day surgery setting.
• To evaluate intraoperative and postoperative clinical conditions, and emergence times for both anesthetic techniques.

Main Methods:

• A study involving 218 patients undergoing plastic or proctologic surgery as day hospital patients.
• Anesthesia administered included general anesthesia (AG) and monitored anesthesia care (MAC) using propofol and remifentanil infusions.
• Data collected included various emergence intervals, drug consumption, and intraoperative/postoperative adverse events; analyzed using variance analysis.

Main Results:

• Emergence intervals were significantly longer under AG compared to MAC.
• Drug consumption was approximately double under AG versus MAC.
• AG showed a higher incidence of intraoperative hypotension and bradycardia; MAC had more frequent SaO2 decrease and itching. Benzodiazepine addition significantly prolonged recovery.

Conclusions:

• Propofol-remifentanil provides excellent conditions for day surgery, ensuring good anesthesia with rapid emergence.
• Monitored anesthesia care (MAC) offers faster recovery than general anesthesia (AG).
• The addition of benzodiazepines, even at low doses, significantly extends discharge times.