Optimal effect-site concentration of remifentanil for preventing development of hypertension during tracheal intubation with inhaled desflurane induction.
- Author:
Kyoung Ok KIM
1
;
Seunghyun CHUNG
;
Eun jung CHANG
;
Younsuk LEE
Author Information
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords: Desflurane; Intubation; Remifentanil effect-site concentration
- MeSH: Androstanols; Female; Humans; Hypertension; Inhalation; Injections, Intravenous; Intubation; Isoflurane; Piperidines; Propofol
- From:Korean Journal of Anesthesiology 2011;60(1):8-11
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: The aim of the present study was to determine the effect-site concentration of remifentanil needed to prevent haemodynamic instability during tracheal intubation with inhaled desflurane induction. METHODS: One hundred American Society of Anesthesiologists I and II female patients were randomized to receive an effect-site concentration of remifentanil of 0, 1, 2, 3, or 4 ng/ml. Induction of anaesthesia was started with intravenous injection of propofol 2 mg/kg. Ninety seconds after the completion of propofol injection, rocuronium (0.8 mg/kg) and remifentanil were administered simultaneously with 3% desflurane inhalation. Tracheal intubation was attempted 150 sec after the commencement of remifentanil administration. RESULTS: A probit model of remifentanil concentration was predictive of successful intubation without development of hypertension (P for goodness-of-fit = 0.419). The effect-site concentration of remifentanil needed to achieve successful intubation without development of hypertension in 95% of the patients was 3.3 ng/ml (95% confidence interval, 2.6-4.8 ng/ml). CONCLUSIONS: The effect-site concentration of remifentanil of 3.3 ng/ml is effective in blunting the haemodynamic response in 95% of the patients when 2.0 mg/kg of propofol induction was followed by 3% desflurane inhalation.
