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The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation.
J Clin Anesth. 2011 Aug; 23(5):379-83.JC

Abstract

STUDY OBJECTIVE

To determine the most suitable effect-site concentration of remifentanil during lightwand intubation when administered with a target-controlled infusion (TCI) of propofol at 4.0 μg/mL without neuromuscular blockade.

DESIGN

Prospective study using a modified Dixon's up-and-down method.

SETTING

Operating room of an academic hospital.

PATIENTS

28 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for minor elective surgery.

INTERVENTIONS

Anesthesia was induced by TCI propofol effect-site concentration to 4.0 μg/mL, and the dose of remifentanil given to each patient was determined by the response of the previously tested patient using 0.2 ng/mL as a step size. The first patient was tested at a target effect-site concentration of 4.0 ng/mL of remifentanil. If intubation was successful, the remifentanil dose was decreased by 0.2 ng/mL; if it failed, the remifentanil dose was increased by 0.2 ng/mL. Successful intubation was defined as excellent or good intubating conditions.

MEASUREMENTS AND MAIN RESULTS

The remifentanil effect-site concentration was measured. The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction using 2% propofol target effect-site concentration to 4 μg/mL was 2.16 ± 0.19 ng/mL. From probit analysis, the effect-site concentration of remifentanil required for successful lightwand intubation in 50% (EC50) and 95% (EC95) of adults was 2.11 ng/mL (95% CI 1.16-2.37 ng/mL) and 2.44 ng/mL (95% CI 2.20-3.79 ng/mL), respectively.

CONCLUSION

A remifentanil effect-site concentration of 2.16 ± 0.19 ng/mL given before a propofol effect-site concentration of 4 μg/mL allowed lightwand intubation without muscle relaxant.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Inha University, College of Medicine, Incheon, 400-103, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21741813

Citation

Han, Jeong Uk, et al. "The Optimal Effect-site Concentration of Remifentanil for Lightwand Tracheal Intubation During Propofol Induction Without Muscle Relaxation." Journal of Clinical Anesthesia, vol. 23, no. 5, 2011, pp. 379-83.
Han JU, Cho S, Jeon WJ, et al. The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation. J Clin Anesth. 2011;23(5):379-83.
Han, J. U., Cho, S., Jeon, W. J., Yeom, J. H., Shin, W. J., Shim, J. H., & Kim, K. H. (2011). The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation. Journal of Clinical Anesthesia, 23(5), 379-83. https://doi.org/10.1016/j.jclinane.2010.12.012
Han JU, et al. The Optimal Effect-site Concentration of Remifentanil for Lightwand Tracheal Intubation During Propofol Induction Without Muscle Relaxation. J Clin Anesth. 2011;23(5):379-83. PubMed PMID: 21741813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation. AU - Han,Jeong Uk, AU - Cho,Sangyun, AU - Jeon,Woo Jae, AU - Yeom,Jong Hoon, AU - Shin,Woo Jong, AU - Shim,Jae Hang, AU - Kim,Kyoung Hun, Y1 - 2011/07/08/ PY - 2009/11/27/received PY - 2010/11/17/revised PY - 2010/12/08/accepted PY - 2011/7/12/entrez PY - 2011/7/12/pubmed PY - 2011/12/13/medline SP - 379 EP - 83 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 23 IS - 5 N2 - STUDY OBJECTIVE: To determine the most suitable effect-site concentration of remifentanil during lightwand intubation when administered with a target-controlled infusion (TCI) of propofol at 4.0 μg/mL without neuromuscular blockade. DESIGN: Prospective study using a modified Dixon's up-and-down method. SETTING: Operating room of an academic hospital. PATIENTS: 28 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for minor elective surgery. INTERVENTIONS: Anesthesia was induced by TCI propofol effect-site concentration to 4.0 μg/mL, and the dose of remifentanil given to each patient was determined by the response of the previously tested patient using 0.2 ng/mL as a step size. The first patient was tested at a target effect-site concentration of 4.0 ng/mL of remifentanil. If intubation was successful, the remifentanil dose was decreased by 0.2 ng/mL; if it failed, the remifentanil dose was increased by 0.2 ng/mL. Successful intubation was defined as excellent or good intubating conditions. MEASUREMENTS AND MAIN RESULTS: The remifentanil effect-site concentration was measured. The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction using 2% propofol target effect-site concentration to 4 μg/mL was 2.16 ± 0.19 ng/mL. From probit analysis, the effect-site concentration of remifentanil required for successful lightwand intubation in 50% (EC50) and 95% (EC95) of adults was 2.11 ng/mL (95% CI 1.16-2.37 ng/mL) and 2.44 ng/mL (95% CI 2.20-3.79 ng/mL), respectively. CONCLUSION: A remifentanil effect-site concentration of 2.16 ± 0.19 ng/mL given before a propofol effect-site concentration of 4 μg/mL allowed lightwand intubation without muscle relaxant. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/21741813/The_optimal_effect_site_concentration_of_remifentanil_for_lightwand_tracheal_intubation_during_propofol_induction_without_muscle_relaxation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(11)00200-5 DB - PRIME DP - Unbound Medicine ER -