The optimal effect-site concentration of remifentanil to attenuate the pain caused by propofol.
10.4097/kjae.2012.63.2.108
- Author:
Jong Yeon LEE
1
;
Hyeonjeong YANG
;
Seok Hwan CHOI
;
Dong Wook SHIN
;
Seung Ki HONG
;
Duk Hee CHUN
Author Information
1. Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea. leah1013@chamc.co.kr
- Publication Type:Original Article
- Keywords:
Effect-site concentration;
Propofol;
Remifentanil
- MeSH:
Adult;
Anesthesia, General;
Female;
Hemodynamics;
Humans;
Piperidines;
Propofol
- From:Korean Journal of Anesthesiology
2012;63(2):108-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The injection pain of propofol is a frequent and well-known adverse effect. This study was designed to determine the optimal effect-site concentration of remifentanil for minimizing injection pain during induction with propofol. METHODS: A total intravenous anesthetic technique was used for patients undergoing general anesthesia and remifentanil was pretreated to reach a certain target concentration before propofol injection. Using Dixon's up-and-down method, the degree of pain described by the patient was used to adjust the target concentration of remifentanil for the next patient. Ten success-failure curves (crossovers) were sought to find the effect-site concentration (EC) of remifentanil for minimizing injection pain of propofol. RESULTS: The EC of remifentanil in 50% and 95% of adult female population (EC50 and EC95) for minimizing injection pain of propofol were 3.09 ng/ml (95% confidence limits [CI] 2.92-3.30 ng/ml) and 3.78 ng/ml (95% CI 3.45-3.95 ng/ml), respectively. Clinically significant hemodynamic compromise or respiratory complications were not found during remifentanil infusion. CONCLUSIONS: Maintaining 3.78 ng/ml EC of remifentanil during induction with propofol attenuate propofol injection pain without serious adverse events in female patients undergoing general anesthesia and this method may provide the patient's comfort without preparing other drugs for pain relief.
