Effects of Remifentanil Plus Propofol for Intravenous Anesthesia on Hemodynamics and Inflammatory Cytokines in Patients Undergoing Orthopedic Surgery

Abstract Introduction: This article aimed to evaluate the effects of remifentanil plus propofol intravenous anesthesia on hemodynamics and inflammatory cytokines in patients undergoing orthopedic surgery. Material and Method: A retrospective analysis was conducted on 90 orthopedic surgery patients at Suzhou Ninth People's Hospital from July 2019 to December 2022. Patients were divided into a Group 1 (remifentanil + propofol) and a Group 2 (fentanyl + propofol), each comprising 45 cases. All patients received intramuscular injections of 0.5 mg atropine and 0.1 g sodium phenobarbital 30 minutes preoperatively, administered via target-controlled infusion systems. The Group 1 was induced with remifentanil, propofol, midazolam, and vecuronium bromide for induction. Maintenance involved propofol at 4–8 mg/(kg·h), remifentanil at 0.1–0.8 μg/(kg·min), and vecuronium bromide at 0.06–0.08 mg/(kg·h). The Group 2 substituted remifentanil with fentanyl, maintaining a fentanyl dose of 1–1.5 μg/(kg·min). Anesthetic efficacy (extubation, recovery time, duration of anesthesia), hemodynamic parameters (SBP, DBP, HR), and inflammatory factor levels (TNF-α, hs-CRP, IL-6) were observed in both groups. Result: The extubation, anesthesia recovery, and anesthesia maintenance time in the Group 1 were lower than in the Group 2 (P < 0.05). The baseline systolic blood pressure (SBP) was higher, and the baseline diastolic blood pressure (DBP) and heart rate (HR) were lower in the Group 1 as compared to the Group 2 (P < 0.05). The levels of tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) in the Group 1 24 h after operation were markedly lower as against the Group 2 (P < 0.05). The levels of inflammatory cytokines such as Hs-CRP and interleukin-6 (IL-6) in the Group 1 were lower than in the Group 2 (P < 0.05). Conclusion: The anesthetic outcome of remifentanil plus propofol is better as against fentanyl combined with propofol, and the changes of hemodynamic indexes in patients undergoing orthopedic surgery are more stable. The level of inflammatory cytokines in the remifentanil-propofol group was lower as against fentanyl-propofol group 24 h after surgery.