Abstract: Objective: To explore the effects of remifentanil and propofol TCI anesthesia on cerebral oxygen metabolism in surgery of brain tumor patients with isoflurane balanced anesthesia. Methods: 36 ASA Ⅰto Ⅱelective intra-cranial tumor patients were randomly divided into the isoflurane balanced anesthesia group(C group) (n=15) and the TCI group(R group) (n=21). Patients in the R group were inducted by propofol TCI with plasma concentration 3μg/ml and remifentanil TCI with plasma concentration 6ng/ml and they were maintained with remifentanil and propofol TCI anesthesia. The plasma concentrations were determined based on the stimulus and patients′ response in the surgery procedure. Patients in the C group were inducted by propofol 2mg/kg, fentanyl 0.2μg/kg and vecuronium 0.1mg/kg-1. After intubation, 1% to 2% isoflurane and vecuronium were administered based on the stimulus and patients′ response in the surgery procedure. The BP, HR, SpO₂ and PETCO₂ were determined at pre-induction(T₁), intubation(T₂), 5 min after intubation (T₃), slicing the duramater(T₄), 30min after removing the tumor (T₅), the end of the operation (T₆)and extubation(T₇) and the recover time was also determined. Meanwhile the SjvO₂ and Da-jvO₂ were determined at pre-induction（t₁）, 30min after induction(t₂), 1h after induction (t₃), 2h after induction(t₄), and extubation(t₅). Results: Patients′ BP, HR, SpO₂ and PETCO₂ were similar between the two groups（P＞0.05）. In both groups, patients′ BP significantly decreased after induction（P＜0.05）. Patients in the C group recovered more slowly than those in the R group（P＜0.05）. SjvO₂ of the C group was higher than that of the R group, while Ca-jvDO₂ of the C group was lower than that of the R group at time of t₂, t₃ and t₄（P＜0.05）. SjvO₂ at t₂, t₃ and t₄ was higher than that at t₁, while Da-jvO₂ at t₂, t₃ and t₄ was lower than that at t₁ in the C group（P＜0.05）. Conclusions: Both remifentanil and propofol TCI anesthesia and isoflurane balanced anesthesia can maintain smooth life signs in surgery of cerebral tumor patients. Patients anesthetized with remifentanil and propofol TCI recover more quickly than those anesthetized with isoflurane balanced anesthesia. Remifentanil and propofol TCI anesthesia can balance the oxygen supply consumption better than isoflurane balanced anesthesia do during the operation.

Key words: Remifentanil, Propofol, Target-controlled infusion, Cerebral oxygen metabolism