Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia.
10.4097/kjae.2011.60.6.398
- Author:
Jun Heum YON
1
;
Jae Keun JO
;
Young Suk KWON
;
Hae Gyun PARK
;
Sangseok LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. sslee@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Effect-site concentration;
Light wand;
Remifentanil;
Tracheal intubation
- MeSH:
Adult;
Aged;
Anesthesia;
Anesthesia, Intravenous;
Hemodynamics;
Humans;
Intubation;
Laryngoscopes;
Light;
Piperidines;
Propofol;
Transillumination
- From:Korean Journal of Anesthesiology
2011;60(6):398-402
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Transillumination using a light wand is an alternative type of laryngoscope used for tracheal intubation. There is little information available on the effect-site concentration of remifentanil required to control hemodynamic changes induced by tracheal intubation using the transillumination method during total IV anesthesia. We therefore conducted this study to determine the effect-site concentration of remifentanil blunting hemodynamic responses after tracheal intubation in patients receiving propofol anesthesia. METHODS: We enrolled 26 healthy adult patients (ASA physical status I-II), aged 16-67 scheduled for surgery within 2 hours. All patients received a target-controlled infusion of 4 microg/ml propofol. The effect-site target-concentration of remifentanil of 5.0 ng/ml was chosen for the first patient. We used the Dixon's up-and-down sequential allocation method for determining the next remifentanil concentration. The time required for tracheal intubation was measured as the level of intubation stimulation. RESULTS: The average intubation time was 13.9 +/- 9.1 seconds. From the Dixon's method, the EC50 of remifentanil blunting the hemodynamic response to tracheal intubation was 2.94 ng/ml. CONCLUSIONS: This study shows that effect-site concentrations of remifentanil of 2.94 ng/ml is effective in blunting sympathetic responses to tracheal intubation in 50% of patients with normal airway anatomy when combined with a target controlled infusion of propofol (4 microg/ml).
