Adequate Combination of Target Effect-site Concentration of Propofol and Remifentanil for Tracheal Intubation.
10.4097/kjae.2008.54.1.37
- Author:
Jong In HAN
1
;
Heeseung LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. hanji@ewha.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
bispectral index;
effect-site concentration;
hemodynamic;
propofol;
remifentanil;
target-controlled infusion
- MeSH:
Androstanols;
Blood Pressure;
Heart Rate;
Hemodynamics;
Humans;
Intubation;
Piperidines;
Propofol;
Unconsciousness
- From:Korean Journal of Anesthesiology
2008;54(1):37-42
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We wanted to determine an adequate combination of target effect-site concentrations of remifentanil and propofol during anesthetic induction with target controlled infusion (TCI).We also determined whether increasing remifentanil concentrations might reduce propofol consumption at loss of consciousness (LOC). METHODS: Sixty ASA 1 or 2 patients were randomly allocated according to the target effect-site concentration of remifentanil and propofol (R7P3: remifentanil 7 ng/ml + propofol 3microgram/ml, R5P4: remifentanil 5 ng/ml + propofol 4microgram/ml, R3P5: remifentanil 3 ng/ml + propofol 5microgram/ml). After the target effect-site concentration of remifentanil had been reached, the TCI of propofol was started. The effect-site concentration of propofol at LOC was recorded. When the target effect-site concentration of propofol was reached, 0.6 mg/kg of rocuronium was administered. Tracheal intubation was performed after 2 minutes. The noninvasive blood pressure, heart rate (HR), bispectral index (BIS), and infused dose of remifentanil and propofol were recorded. RESULTS: R3P5 groupd showed a significant increase in mean blood pressure after intubation (104 +/- 31.9 mmHg, P < 0.05) compared to R7P3 and R5P4. BIS at the time when propofol reached its target effect-site concentration was significantly higher in the R7P3 group (71.6 +/- 9.9, P < 0.05 compared to R5P4 and R3P5). There was a significant relationship between the effect-site concentration of remifentanil and propofol at LOC (Y = 2.032 - 0.351X, R(2) = 0.551, P < 0.0001). CONCLUSIONS: The R5P4 target effect-site concentrations are adequate dosing combinations during TCI induction based on hemodynamic responses and BIS values.
