Comparison of effect-site concentration of remifentanil for tracheal intubation with the lightwand and laryngoscopy during propofol target-controlled infusion.
10.4097/kjae.2011.60.6.393
- Author:
Jin Soo KIM
1
;
Dae Hee KIM
;
Sang Kee MIN
;
Kyung Mi KIM
;
Jong Yeop KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. kjyeop@ajou.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Intubation;
Lightwand;
Propofol;
Remifentanil;
Target-controlled infusion
- MeSH:
Adult;
Anesthesia;
Humans;
Intubation;
Laryngoscopes;
Laryngoscopy;
Neuromuscular Blockade;
Piperidines;
Propofol
- From:Korean Journal of Anesthesiology
2011;60(6):393-397
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Target-controlled infusion (TCI) of propofol and remifentanil can provide satisfactory intubating conditions without a neuromuscular blocking agent. We compared the effect-site concentration of remifentanil required for intubation with the lightwand and the Macintosh laryngoscope during propofol TCI without a neuromuscular blocking agent in adult patients. METHODS: Forty-nine patients were randomly assigned to the lightwand group (n = 25) or the direct laryngoscope group (n = 24). Anesthesia was induced by propofol TCI with an effect-site concentration of 5.4 microg/ml. Two minutes after start of propofol TCI, remifentanil was administered at the predetermined effect-site concentration. The effect-site concentration of remifentanil was determined using Dixon's up-and-down method (0.5 ng/ml as a step size). The first patient in each group was tested at 4.5 ng/ml of remifentanil. Tracheal intubation was performed 2 min after the start of remifentanil TCI. Acceptable intubation was defined as an excellent or good intubating conditions. RESULTS: Using a modified Dixon's up and down method, the EC50 +/- SD of remifentanil in the lightwand and laryngoscope groups was 4.75 +/- 0.71 ng/ml and 5.08 +/- 0.52 ng/ml, respectively; there was no statistically significant difference between the groups (P = 0.373). CONCLUSIONS: The effect-site concentration of remifentanil for acceptable intubation with the lightwand and Macintosh laryngoscope in 50% of adults did not differ during propofol TCI without a neuromuscular blocking agent.
