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Total intravenous anesthesia with propofol: Case report
Wen-fei Tan, Hong Ma
Department of Anesthesiology, the First Hospital of China Medical University
Corresponding Author: Hong Ma, E-mail: mahong5466@yahoo.com
It is difficult for anesthesia care providers to reliably the uncomfortable experience of dyspnea. He woke up
detect residual neuromuscular block in the operation room from anesthesia with residual neuromuscular blockade
using standard clinical criteria. Respiratory function can be every time. It is also can explain the reasons of nausea and
subtle affected during minimal neuromuscular blockade, vomitting and sore throat with inhalation and endotracheal
which is the only complain of some patients undergoing intubation.
general anesthesia. Studies have suggested that total
intravenous anesthesia (TIVA) with propofol reduces the According to the requirement of the surgery, that is
incidence of postoperation nausea and vomiting (PONV) immobility、amnesia and short-stay surgical procedure,
and results in shorter emergence time.［1］ We report we designed the plan of anesthesia. Aim of anesthesia is to
one anesthesia case with total intravenous anesthesia of make sure the patient is safe and feel comfortable. General
propofol and remifentanyl without neuromuscular block, anesthesia was induced with propofol (2mg/kg) and
and get very satisfied outcome. remifentanyl (1μg/kg) to facilitate laryngeal mask airway
(LMA) insertion. With 5-10 minutes of assistant ventilation,
Case report patients were left in spontaneous ventilation. Anesthesia
was maintained with 6-8 mg/kg/h propofol and 0.2-0.3μg/
A 52-year-old male patient was diagnosed as kg/h remifentanyl to keep BIS between 40 and 60. After
papilloma of bladder. The patient had a medical history 25 minutes of surgery, the patient was awakened in the
of hypersplenia. He underwent transurethral resection operating room comfortably.
of bladder tumor (TURB) with for 6 times without
complications. All of the 6 operations were done with Discussion
general anesthesia. At the interview before operation, the
patient had complains of dyspnea、nausea、vomitting In conclusion, we have shown rapid recovery of
and sore throat about his feeling of all these 6 times of spontaneous ventilation when propofol and remifntanil
anesthesia. The most uncomfortable experience of the were used.
anesthesia was dyspnea. Also, the 6 anesthesia reports of
the patient shows that he underwent general anesthesia Compared with inhalation, the incidence of side
with muscle relaxant、endotracheal intubation and effects, specifically PONV, was less frequent with propofol.
inhalation. The operation time was not more than 30 1 Thinking about the PONV history of this patient, we
minutes every time. It is the reason why the patient had preferred propofol to sevoflurane. Also, insertion of
the LMA under deep inhaled anesthesia alone is not
Laboratory and Clinical CInavseesRtigeaptoiortn 67 FAM 2014 Jan/Feb Vol.21 Issue 1
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