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Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial.
BMC Anesthesiol. 2015 Oct 06; 15:131.BA

Abstract

BACKGROUND

A new supraglottic device, the LMA-Supreme™, has recently become available for clinical use. Information on anaesthetic and co-adjuvant requirements for insertion of the LMA-Supreme™ is limited. The present study aimed to evaluate the optimal effect-site concentration of propofol in 50 % (EC50) of adults necessary for successful insertion of the LMA-Supreme™ and to examine remifentanil's effect on propofol requirements.

METHODS

Fifty-eight elective patients (aged 18-60 years; ASA (American Society Anaesthesiologists) physical status classification I and II) scheduled for day surgery were randomly assigned to one of two groups: propofol with saline or propofol with remifentanil. Anaesthesia was induced by target-controlled infusion according to predetermined effect-site concentrations of propofol and remifentanil (5 ng.mL(-1)). The EC50 was calculated using Dixon's up-and-down method. Ten minutes following drug administration, LMA-Supreme™ insertion was attempted without the use of muscle relaxant drugs.

RESULTS

In the propofol + saline group, the EC50 of propofol required for LMA-Supreme™ insertion was 6.32 ± 0.67 μg.mL(-1) (95 % CI, 5.69-6.94 μg.mL(-1)). With the addition of remifentanil at an effect-site concentration of 5 ng.mL(-1), the EC50 of propofol required for LMA-Supreme™ insertion was 2.50 ± 0.80 μg.mL(-1) (95 % CI, 1.82-3.17 μg.mL(-1); p < 0.0001).

CONCLUSIONS

The propofol requirement for smooth insertion of the LMA-Supreme™ was 60 % less when remifentanil (5 ng.mL(-1)) was co-administered.

CLINICAL TRIAL REGISTRATION

Identified as NCT01974648 at www.clinicaltrials.gov .

Authors+Show Affiliations

Department of Toxicology, Faculty of Medicine, Complutense University, Madrid, Spain. mati@plagaro.net. Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. mati@plagaro.net.Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. emiliabastida@gmail.com.Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. s.agusti@hotmail.com.Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. maiteportas@gmail.com.Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. consuelojdf@gmail.com.Department of Anaesthesia, Head Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain. mlopezgi@yahoo.es.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26438179

Citation

Zaballos, Matilde, et al. "Effect-site Concentration of Propofol Required for LMA-Supreme™ Insertion With and Without Remifentanil: a Randomized Controlled Trial." BMC Anesthesiology, vol. 15, 2015, p. 131.
Zaballos M, Bastida E, Agustí S, et al. Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial. BMC Anesthesiol. 2015;15:131.
Zaballos, M., Bastida, E., Agustí, S., Portas, M., Jiménez, C., & López-Gil, M. (2015). Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial. BMC Anesthesiology, 15, 131. https://doi.org/10.1186/s12871-015-0115-8
Zaballos M, et al. Effect-site Concentration of Propofol Required for LMA-Supreme™ Insertion With and Without Remifentanil: a Randomized Controlled Trial. BMC Anesthesiol. 2015 Oct 6;15:131. PubMed PMID: 26438179.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial. AU - Zaballos,Matilde, AU - Bastida,Emilia, AU - Agustí,Salomé, AU - Portas,Maite, AU - Jiménez,Consuelo, AU - López-Gil,Maite, Y1 - 2015/10/06/ PY - 2014/12/01/received PY - 2015/09/24/accepted PY - 2015/10/7/entrez PY - 2015/10/7/pubmed PY - 2016/6/25/medline SP - 131 EP - 131 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 15 N2 - BACKGROUND: A new supraglottic device, the LMA-Supreme™, has recently become available for clinical use. Information on anaesthetic and co-adjuvant requirements for insertion of the LMA-Supreme™ is limited. The present study aimed to evaluate the optimal effect-site concentration of propofol in 50 % (EC50) of adults necessary for successful insertion of the LMA-Supreme™ and to examine remifentanil's effect on propofol requirements. METHODS: Fifty-eight elective patients (aged 18-60 years; ASA (American Society Anaesthesiologists) physical status classification I and II) scheduled for day surgery were randomly assigned to one of two groups: propofol with saline or propofol with remifentanil. Anaesthesia was induced by target-controlled infusion according to predetermined effect-site concentrations of propofol and remifentanil (5 ng.mL(-1)). The EC50 was calculated using Dixon's up-and-down method. Ten minutes following drug administration, LMA-Supreme™ insertion was attempted without the use of muscle relaxant drugs. RESULTS: In the propofol + saline group, the EC50 of propofol required for LMA-Supreme™ insertion was 6.32 ± 0.67 μg.mL(-1) (95 % CI, 5.69-6.94 μg.mL(-1)). With the addition of remifentanil at an effect-site concentration of 5 ng.mL(-1), the EC50 of propofol required for LMA-Supreme™ insertion was 2.50 ± 0.80 μg.mL(-1) (95 % CI, 1.82-3.17 μg.mL(-1); p < 0.0001). CONCLUSIONS: The propofol requirement for smooth insertion of the LMA-Supreme™ was 60 % less when remifentanil (5 ng.mL(-1)) was co-administered. CLINICAL TRIAL REGISTRATION: Identified as NCT01974648 at www.clinicaltrials.gov . SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/26438179/Effect_site_concentration_of_propofol_required_for_LMA_Supreme™_insertion_with_and_without_remifentanil:_a_randomized_controlled_trial_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-015-0115-8 DB - PRIME DP - Unbound Medicine ER -