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The effect of adding two target-controlled concentrations (1-3 ng mL -1) of remifentanil on MAC BAR of desflurane.
Eur J Anaesthesiol. 2006 Jun; 23(6):510-6.EJ

Abstract

BACKGROUND AND OBJECTIVES

The aim of this prospective, randomized, double-blind study was to determine the effects of adding two different target-controlled concentrations of remifentanil (1 and 3 ng mL(-1)) on the desflurane requirement for blunting sympathetic responses after surgical incision (minimum anaesthetic concentration (MAC(BAR)).

METHODS

67 patients, aged 20-50 yr, ASA I, undergoing general anaesthesia for elective abdominal surgery were enrolled and randomly allocated to receive no remifentanil infusion (n = 21) or a target-controlled effect-site concentration of 1 ng mL(-1) (n = 24) or 3 ng mL(-1) remifentanil (n = 22). All patients were anaesthetized with propofol, cisatracurium and desflurane with a mixture of 60% nitrous oxide in oxygen. Sympathetic responses to surgical incision were determined after a 20-min period of stable end-tidal desflurane and target-controlled remifentanil concentrations. Predetermined end-tidal desflurane concentrations and the MAC(BAR) for each group were determined using an up-and-down sequential-allocation technique.

RESULTS

The MAC(BAR) of desflurane was higher in the group receiving no remifentanil (6.25% [95% confidence interval: 5.9-6.5%]) as compared with patients of the groups receiving 1 ng mL(-1) (2.7% [2.6-2.8%]; P < 0.001) and 3 ng mL(-1) remifentanil (2% [1.9-2.2%]; P < 0.01). When considering a MAC value in this age population and the contribution of 60% nitrous oxide (0.55 MAC), the combined MAC(BAR) values, expressed as multiples of the MAC, were 1.9, 0.8 and 0.6 MAC, in the three groups, respectively.

CONCLUSION

A target-controlled concentration of 1 ng mL(-1) remifentanil results in a 57% decrease in the MAC(BAR) of desflurane combined with 60% nitrous oxide. Increasing the target concentration of remifentanil to 3 ng mL(-1) produces a further 26% decrease in the MAC(BAR) values of desflurane.

Authors+Show Affiliations

Department of Anesthesiology, IRCCS H. San Raffaele, Vita-Salute University of Milano, Milan, Italy. albertin.andrea@hsr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16672093

Citation

Albertin, A, et al. "The Effect of Adding Two Target-controlled Concentrations (1-3 Ng mL -1) of Remifentanil On MAC BAR of Desflurane." European Journal of Anaesthesiology, vol. 23, no. 6, 2006, pp. 510-6.
Albertin A, Dedola E, Bergonzi PC, et al. The effect of adding two target-controlled concentrations (1-3 ng mL -1) of remifentanil on MAC BAR of desflurane. Eur J Anaesthesiol. 2006;23(6):510-6.
Albertin, A., Dedola, E., Bergonzi, P. C., Lombardo, F., Fusco, T., & Torri, G. (2006). The effect of adding two target-controlled concentrations (1-3 ng mL -1) of remifentanil on MAC BAR of desflurane. European Journal of Anaesthesiology, 23(6), 510-6.
Albertin A, et al. The Effect of Adding Two Target-controlled Concentrations (1-3 Ng mL -1) of Remifentanil On MAC BAR of Desflurane. Eur J Anaesthesiol. 2006;23(6):510-6. PubMed PMID: 16672093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of adding two target-controlled concentrations (1-3 ng mL -1) of remifentanil on MAC BAR of desflurane. AU - Albertin,A, AU - Dedola,E, AU - Bergonzi,P C, AU - Lombardo,F, AU - Fusco,T, AU - Torri,G, PY - 2006/01/15/accepted PY - 2006/5/5/pubmed PY - 2006/12/9/medline PY - 2006/5/5/entrez SP - 510 EP - 6 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 23 IS - 6 N2 - BACKGROUND AND OBJECTIVES: The aim of this prospective, randomized, double-blind study was to determine the effects of adding two different target-controlled concentrations of remifentanil (1 and 3 ng mL(-1)) on the desflurane requirement for blunting sympathetic responses after surgical incision (minimum anaesthetic concentration (MAC(BAR)). METHODS: 67 patients, aged 20-50 yr, ASA I, undergoing general anaesthesia for elective abdominal surgery were enrolled and randomly allocated to receive no remifentanil infusion (n = 21) or a target-controlled effect-site concentration of 1 ng mL(-1) (n = 24) or 3 ng mL(-1) remifentanil (n = 22). All patients were anaesthetized with propofol, cisatracurium and desflurane with a mixture of 60% nitrous oxide in oxygen. Sympathetic responses to surgical incision were determined after a 20-min period of stable end-tidal desflurane and target-controlled remifentanil concentrations. Predetermined end-tidal desflurane concentrations and the MAC(BAR) for each group were determined using an up-and-down sequential-allocation technique. RESULTS: The MAC(BAR) of desflurane was higher in the group receiving no remifentanil (6.25% [95% confidence interval: 5.9-6.5%]) as compared with patients of the groups receiving 1 ng mL(-1) (2.7% [2.6-2.8%]; P < 0.001) and 3 ng mL(-1) remifentanil (2% [1.9-2.2%]; P < 0.01). When considering a MAC value in this age population and the contribution of 60% nitrous oxide (0.55 MAC), the combined MAC(BAR) values, expressed as multiples of the MAC, were 1.9, 0.8 and 0.6 MAC, in the three groups, respectively. CONCLUSION: A target-controlled concentration of 1 ng mL(-1) remifentanil results in a 57% decrease in the MAC(BAR) of desflurane combined with 60% nitrous oxide. Increasing the target concentration of remifentanil to 3 ng mL(-1) produces a further 26% decrease in the MAC(BAR) values of desflurane. SN - 0265-0215 UR - https://www.unboundmedicine.com/medline/citation/16672093/The_effect_of_adding_two_target_controlled_concentrations__1_3_ng_mL__1__of_remifentanil_on_MAC_BAR_of_desflurane_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=16672093.ui DB - PRIME DP - Unbound Medicine ER -