Up-and-down sequential method in determining median effective effect-site concentration (EC5O) of remifentanil required for inhibiting intubation-inducedhemodynamic responses in patients with parkinson's disease during target-controlled infusion of propofol
10.3724/sp.j.1008.2013.00868
- Author:
Xiao-Ping XU
1
Author Information
1. Department of Anesthesiology, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Henmodynamic responses;
Parkinson disease;
Propofol;
Remifentanil
- From:
Academic Journal of Second Military Medical University
2013;34(8):868-873
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the median effective effect-site concentration (EC50) of remifentanil required to inhibit hemodynamic responses induced by intubation during target-controlled infusion (TCI) of propofol in patients with Parkinson' disease. Methods A1 (1 matched case control design was used in the study. Thirty-one ASA I E patients with Parkinson's disease undergoing general anesthesia were enrolled, and 31 controls were the hospitalized patients with non-Parkinson' disease during the same period (same sex, age ±3 years old). A TCI of propofol was used to maintain a predetermined effect-site concentrationof 3 fg/mL. The target effect-site concentration of remifentanil was determined by a modified Dixon' up-and-down sequential method. The initial target effect-site concentrations of remifentanil were 3 ng/mL in the two groups and the increments or decrements between the two consecutive patients were 0. 2ng/mL. A positive response meant that either the heart rate or the systolic blood pressure was elevated by 15% in the first5 min after intubation. Results There was no patient showed sign of muscle rigidity, and no patient recalled awareness during anesthesia in postoperative follow-up. During TCI of propofol, the EC50 of remifentanil required for inhibiting intubation induced hemodynamic responses for patientswith Parkinson' disease was 2. 20 ng/mL (95% confidence interval: 1. 86-2. 60 ng/mL). And the EC50f remifentanil required for control group was significantly higher than for patients with Parkinson' disease (2. 93 ng/mL, 95% confidence interval: 2. 72-3. 15 ng/mL). Conclusion When combined with TCI of propofol (target effect-site concentration 3 μg/mL), the EC50f remifentanil required for inhibiting intubation induced hemodynamic responses for patients with Parkinson' disease is less than that for non-Parkinson' disease.
