Tracheal Intubating Conditions and Hemodynamic Change in Ambulatory Surgery: Propofol and Remifentanil Target Controlled Infusions with Low Dose Rocuronium.
10.4097/kjae.2006.51.5.535
- Author:
Jong Yeop KIM
1
;
Jae Hyung KIM
;
Sung Yong PARK
;
Hyun Ho LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, Korea. kjyeop@ajou.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
hemodynamics;
intubating conditions;
remifentanil;
rocuronium
- MeSH:
Ambulatory Surgical Procedures*;
Anesthesia;
Arterial Pressure;
Heart Rate;
Hemodynamics*;
Humans;
Intubation;
Midazolam;
Neuromuscular Blockade;
Propofol*;
Trachea
- From:Korean Journal of Anesthesiology
2006;51(5):535-540
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: This study evaluated the tracheal intubating conditions and hemodynamic changes in tracheal intubation according to the different effect-site concentrations of remifentanil combined with a target controlled infusion (TCI) of propofol using low dose rocuronium. METHODS: Forty-five patients presenting for ambulatory surgery were randomly assigned to one of three groups according to the target effect-site concentration of remifentanil: 2.5 ng/ml (group R2.5), 3.0 ng/ml (group R3.0), 3.5 ng/ml (group R3.5). After midazolam administration, anesthesia was induced using a target effect-site controlled infusion of propofol 4.0microgram/ml, which was then reduced to 2.5microgram/ml. At the same time, a TCI of remifentanil was started. A neuromuscular blockade was produced by rocuronium 0.4 mg/kg. The trachea was intubated 4 min after induction. The tracheal intubation conditions were assessed using a standard scoring system. The noninvasive arterial blood pressure, heart rate (HR), and bispectral index were recorded at 1 min intervals from the start of induction to 5 min after intubation. RESULTS: Intubation was successful in all patients except for one in the R2.5 group. The number of excellent intubating conditions was significantly higher in the R3.5 group (12/15) than in the R2.5 group (6/15) (P < 0.05). The mean arterial pressure (MAP) in the R2.5 and R3.0 groups increased significantly at 1 min after intubation (P < 0.05), but the MAP in the R3.5 group increased slightly at 1 min after intubation. CONCLUSIONS: The effect-site concentration of remifentanil 3.5 ng/ml combined with a TCI of propofol using rocuronium 0.4 mg/kg provides the most adequate intubating conditions and hemodynamic stability.
