Remifentanil dose for laryngeal mask airway insertion with a single standard dose of propofol during emergency airway management in elderly patients.
10.4097/kjae.2014.66.4.278
- Author:
Junghee RYU
1
;
Ah Young OH
;
Ji Seok BAEK
;
Jin Hee KIM
;
Sang Heon PARK
;
Jae Mun NOH
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea. oay1@snubh.org
- Publication Type:Original Article
- Keywords:
Aged;
Laryngeal mask airway;
Remifentanil
- MeSH:
Aged*;
Airway Management*;
Anesthesia;
Emergencies*;
Hemodynamics;
Humans;
Laryngeal Masks*;
Propofol*;
Unconsciousness
- From:Korean Journal of Anesthesiology
2014;66(4):278-282
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study determined the dose of remifentanil to use during insertion of a Classic(TM) laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol. METHODS: Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient's loss of consciousness. The dose of remifentanil was determined using Dixon's up-and-down method, starting at 0.5 microg/kg (a step size of 0.1 microg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness. RESULTS: In total, 23 patients were recruited and the mean age +/- standard deviation was 72 +/- 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 +/- 0.05 microg/kg. No patient needed more than 0.3 microg/kg. CONCLUSIONS: Remifentanil 0.20 +/- 0.05 microg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.
