Optimal effective-site concentration of remifentanil for sedation during plate removal of maxilla
10.17245/jdapm.2018.18.5.295
- Author:
Jeong Hoon PARK
1
;
Ji Young YOON
;
Eun Jung KIM
;
Ji Uk YOON
;
Byung Moon CHOI
;
Ji Hye AHN
Author Information
1. Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea. anji1030@naver.com
- Publication Type:Original Article
- Keywords:
Conscious Sedation, Dexmedetomidine;
Plate Removal;
Remifentanil
- MeSH:
Dexmedetomidine;
Humans;
Maxilla;
Osteotomy
- From:Journal of Dental Anesthesia and Pain Medicine
2018;18(5):295-300
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Removal of the plate following Le Fort I osteotomy and BSSO (bilateral sagittal split osteotomy) is a common procedure. However, patients who undergo plate removal experience intense pain and discomfort. This study investigated the half-maximal effective concentration (Ce50 ) of remifentanil in the prevention of plate removal pain under sedation using dexmedetomidine. METHODS: The study evaluated 18 patients, between 18 and 35 years of age, scheduled for elective surgery. Remifentanil infusion was initiated after sedation using dexmedetomidine, and started at a dose of 1.5 ng/mL on the first patient via target-controlled infusion (TCI). Patients received a loading dose of 1.0 µg/kg dexmedetomidine over 10 min, followed by a maintenance dose of 0.7 µg/kg/h. When the surgeon removed the plate, the patient Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score was observed. RESULTS: The Ce of remifentanil ranged from 0.9 to 2.1 ng/mL for the patients evaluated. The estimated effect-site concentrations of remifentanil associated with a 50% and 95% probability of reaching MOAA/S score of 3 were 1.28 and 2.51 ng/mL, respectively. CONCLUSIONS: Plate removal of maxilla can be successfully performed without any pain or adverse effects by using the optimal remifentanil effect-site concentration (Ce50 , 1.28 ng/mL; Ce95 , 2.51 ng/mL) combined with sedation using dexmedetomidine.
