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

This prospective study evaluated the use of continuous sedation using propofol and remifentanil when carpal tunnel release (CTR) was performed under local anesthesia.

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(-1)min(-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(-1)min(-1) (group B) or 0.1 µg kg(-1)min(-1) (group C).

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.

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.