Recovery from propofol anaesthesia supplemented with remifentanil

We have examined the effects on recovery end-points of supplementation of a propofol-based anaesthetic with remifentanil. After induction of anaesthes ia with propofol and remifentanil 1.0 mug kg(-1). 15 patients each were ran domly allocated to target plasma propofol concentrations of 2, 3, 4 or 5 mu g ml(-1) for maintenance of anaesthesia. Remifentanil was administered by i nfusion for supplementation in doses required for maintenance of adequate a naesthesia. All patients received 50% nitrous oxide in oxygen and ventilati on was controlled. The total amount of drugs used and times to different re covery end-points were recorded. Cognitive function was also assessed using a Mini-Mental State questionnaire. The median dose of remifentanil for mai ntenance of adequate anaesthesia (excluding the initial bolus dose) in the four groups was 0.21, 0.15, 0.11 and 0.13 mug kg(-1) min(-1) respectively ( P=0.0026). The median times to eye opening and orientation were shortest in the 2 mug ml(-1) group [6.0 and 6.5 min, 8.5 and 10.8 min. 13.4 and 15.8 m in, and 14.2 and 19.5 min respectively in the propofol 2, 3, 4, and 5 mug m l(-1) groups respectively (P<0.001)]. The times to discharge from the recov ery ward and the Mini-Mental State scores were nor, significantly different .