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The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation

Title
The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation
Author
조상윤
Keywords
Equipment and supplies; Lightwand; Intubation; Intratracheal; Remifentanil; Effect-site concentrations
Issue Date
2011-09
Publisher
Elsevier Science INC
Citation
Journal of Clinical Anesthesia, 2011, 23(5), P.379-383
Abstract
Study Objective: To determine the most suitable effect-site concentration of remifentanil during lightwand intubation when administered with a target-controlled infusion (TCI) of propofol at 4.0 mu g/mL without neuromuscular blockade.Design: Prospective study using a modified Dixon's up-and-down method.Setting: Operating room of an academic hospital.Patients: 28 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for minor elective surgery.Interventions: Anesthesia was induced by TCI propofol effect-site concentration to 4.0 mu g/mL, and the dose of remifentanil given to each patient was determined by the response of the previously tested patient using 0.2 ng/mL as a step size. The first patient was tested at a target effect-site concentration of 4.0 ng/mL of remifentanil. If intubation was successful, the remifentanil dose was decreased by 0.2 ng/mL; if it failed, the remifentanil close was increased by 0.2 ng/mL. Successful intubation was defined as excellent or good intubating conditions.Measurements and Main Results: The remifentanil effect-site concentration was measured. The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction using 2% propofol target effect-site concentration to 4 mu g/mL was 2.16 +/- 0.19 ng/mL. From probit analysis, the effect-site concentration of remifentanil required for successful lightwand intubation in 50% (EC50) and 95% (EC95) of adults was 2.11 ng/mL (95% CI 1.16-2.37 ng/mL) and 2.44 ng/mL (95% Cl 2.20-3.79 ng/mL), respectively.Conclusion: A remifentanil effect-site concentration of 2.16 +/- 0.19 ng/mL given before a propofol effect-site concentration of 4 mu g/mL allowed lightwand intubation without muscle relaxant.
URI
https://www.sciencedirect.com/science/article/pii/S0952818011002005?via%3Dihubhttps://repository.hanyang.ac.kr/handle/20.500.11754/73560
ISSN
0952-8180
DOI
10.1016/j.jclinane.2010.12.012
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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