The effects of midazolam and remifentanil on induction of anesthesia and hemodynamics during tracheal intubation under target-controlled infusion of propofol.
10.4097/kjae.2009.56.6.619
- Author:
Mi Kyoung SON
1
;
Guie Yong LEE
;
Chi Hyo KIM
;
Rack Kyung CHUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea. lgyanes@mm.ewha.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Combined induction;
Midazolam;
Propofol;
Remifentanil;
Target-controlled infusion
- MeSH:
Androstanols;
Anesthesia;
Anesthetics;
Blood Pressure;
Heart Rate;
Hemodynamics;
Humans;
Intubation;
Midazolam;
Piperidines;
Propofol;
Unconsciousness
- From:Korean Journal of Anesthesiology
2009;56(6):619-623
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The combined induction using two or more agents has a potential benefit that anesthesia could be induced with smaller anesthetic agents with fewer side effects. We studied the effects of co-administration with midazolam and remifentanil on the dose of propofol, the time to loss of consciousness (LOC) and hemodynamics during tracheal intubation. METHODS: Sixty patients were randomly assigned to three groups. Group 1 was induced with target-controlled propofol alone. Group 2 received midazolam (0.05 mg/kg) and target-controlled propofol. Group 3 received midazolam (0.025 mg/kg), remifentanil (2 ng/ml) and target-controlled propofol. The time to LOC, the infused propofol dose and the effect site concentration at LOC were recorded. After LOC, rocuronium (0.6 mg/kg) was given and tracheal intubation was performed. The noninvasive blood pressure, heart rate (HR) and bispectral index were recorded. RESULTS: The time and the dose of propofol to LOC were significantly reduced in group 2, 3 than in group 1 (P < 0.05). Compared with pre-induction values, mean blood pressure at immediately after intubation was increased in group 1, 2 with no change in group 3. The HR immediately after intubation was significantly increased in all groups compared to the pre-induction values, but the rate of increase of HR in group 3 were significantly lower than those group 1, 2 (P < 0.05). CONCLUSIONS: The co-administration with midazolam and remifentanil reduces the time to LOC and the dose of propofol. That also attenuates hemodynamics during tracheal intubation under target-controlled infusion of propofol.
