What is an Optimal Effect Site Concentration of Remifentanil for Minimizing the Hemodynamic Change to Endotracheal Intubation using Light Wand?.
10.4097/kjae.2007.52.3.278
- Author:
Jeoung Hyuk LEE
1
;
Woo Jae JEON
;
Jae Hang SHIM
;
Sang Yoon CHO
;
Jong Hoon YEOM
;
Woo Jong SHIN
;
Kyoung Hun KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea. goldnan@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
intubation;
light wand;
propofol;
remifentanil;
target controlled infusion
- MeSH:
Anesthesia;
Anesthesia, General;
Baroreflex;
Blood Pressure;
Heart Rate;
Hemodynamics*;
Humans;
Intubation;
Intubation, Intratracheal*;
Ketamine;
Propofol
- From:Korean Journal of Anesthesiology
2007;52(3):278-283
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In the previous studies, remifentanil reduces the hemodynamic change induced by endotracheal intubation. We studied the optimal effect site concentration of remifentanil for endotracheal intubation using light wand. METHODS: Sixty ASA 1 or 2 patients scheduled for elective surgery under general anesthesia were classified in three groups according to the TCI (target controlled infusion) dose of remifentanil. Each group was administered 4microgram/ml of propofol TCI, rocuronium, with 2 ng/ml (group 1), 4 ng/ml (group 2), 6 ng/ml (group 3) of remifentanil TCI. Blood pressure, heart rate and bispectral index score were measured before induction, 3 minutes after remifentanil and propofol TCI, after endotracheal intubation using light wand, and 3 minutes after endotracheal intubation. Statistical analysis was done for comparison of time and dose dependant change among the groups. RESULTS: After endotrachal intubation, blood pressure and heart rate were significantly increased in group 1, and decreased in group 2 and 3. 3 minute after endotracheal intubation, heart rate significantly decreased in group 3, but there were no changes in group 2. CONCLUSIONS: The spontaneous BRS was decreased during ketamine induction of general anesthesia. These results suggest that anesthesia induction with ketamine impairs baroreflex control of heart rate, which may provoke hemodynamic instability.
