| The Effect-Site Concentration of Remifentanil for Prevention of Increase of Blood Pressure and Heart Rate to Tracheal Intubation during Propofol-Remifentanil Total Intravenous Anesthesia in Korean. |
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Helen Ki Shinn, Hong Sik Lee, Choon Soo Lee, Chong Kweon Chung, Doo Cheon Cha, Hye Ha Kim, Jang Ho Song |
1Department of Anesthesiology and Pain Medicine, College of Medicine, Inha University, Incheon, Korea. snoguy@freechal.com
2Seoul Women's Hospital, Incheon, Korea. |
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| Abstract |
BACKGROUND
Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences.
METHODS
Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation.
RESULTS
The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups.
CONCLUSIONS
Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences. |
| Key Words:
propofol; remifentanil; sex differences; target-controlled infusion (TCI); tracheal intubation |
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