Predicted Effect-site Concentration of Remifentanil for Facilitating Laryngeal Mask Airway Insertion with Propofol Target-Controlled Infusion.
10.4097/kjae.2007.52.4.381
- Author:
Jong Yeop KIM
1
;
Sung Yong PARK
;
Bong Ki MOON
;
Do Wan KIM
;
Jin Soo KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea. jskane@madang.ajou.ac.kr
- Publication Type:Original Article
- Keywords:
effect-site;
laryngeal mask airway;
propofol;
remifentanil
- MeSH:
Adult;
Anesthesia;
Hemodynamics;
Humans;
Laryngeal Masks*;
Premedication;
Propofol*
- From:Korean Journal of Anesthesiology
2007;52(4):381-385
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The addition of remifentanil during the propofol induced anesthesia facilitates the insertion of laryngeal mask airway (LMA) with minimal adverse hemodynamic disturbances. This study predicted the optimal effect-site concentration of remifentanil for LMA insertion with propofol target-controlled infusion (TCI). METHODS: In 25 adults patients, aged 18-60 years, anesthesia was induced with propofol TCI at the effect-site concentration of 4microgram/ml. Two minutes later, the predetermined effect-site concentration of remifentanil was started. The remifentanil concentration was determined using modified Dixon's up-and-down method (0.5 ng/ml as a step size). The first patient was tested at 2.0 ng/ml remifentanil. The insertion of LMA was attempted 3 min after remifentanil TCI began. The response of the patients to the insertion of LMA was classified as either 'movement' or 'no movement'. RESULTS: The remifentanil concentration at which there was a 50% probability of successful LMA insertion (EC50) was 3.18 +/- 0.53 ng/ml. From probit analysis, the EC50 of remifentanil was 3.10 ng/ml (95% confidence limits, 2.55-4.11 ng/ml), and the EC95 was 4.31 ng/ml (95% confidence limits, 3.64-11.11 ng/ml). CONCLUSIONS: The predicted effect-site concentration of remifentanil for facilitating LMA insertion was 3.18 ng/ml in 50% of adults during propofol TCI at an effect-site concentration of 4microgram/ml without premedication.
