• Annelies T Moerman, Michel M R F Struys, Hugo E Vereecke, Luc L Herregods, Martine M De Vos, and Eric P Mortier.
• Department of Anesthesiology, Ghent University Hospital, Gent, Belgium. annelies.moerman@ugent.be
• J Clin Anesth. 2004 Jun 1;16(4):237-43.

Study ObjectiveTo evaluate whether the use of remifentanil to supplement propofol during spontaneous respiration confers any benefits in terms of quality of sedation and recovery, or in terms of reduction in propofol requirements.DesignProspective, randomized, double-blind study.SettingUniversity hospital.Patients50 ambulatory adult ASA physical status I and II patients scheduled for total colonoscopy.InterventionsPatients were randomized to receive either propofol alone or propofol plus remifentanil 0.1 microg/kg/min, while independently maintaining spontaneous respiration.MeasurementsCardiovascular and respiratory variables were measured before induction and at 1-minute intervals thereafter. Recovery from anesthesia was assessed using simple verbal commands and the Steward Post Recovery Score. Patient satisfaction was measured with a visual analog scale. Computer simulation was used to calculate the effect-site concentrations of propofol and remifentanil.Main ResultsThe depressant effects on blood pressure and respiratory function were significantly higher when propofol and remifentanil were combined. Although the addition of remifentanil resulted in a decrease of propofol usage, recovery of anesthesia was faster and patient satisfaction was higher when using propofol alone.ConclusionsThe addition of remifentanil to propofol during spontaneous ventilation offered no benefits compared with the use of propofol alone.

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