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Comparison of remifentanil EC50 for facilitating i-gel and laryngeal mask airway insertion with propofol anesthesia.
J Anesth. 2016 06; 30(3):377-83.JA

Abstract

OBJECTIVE

Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to compare the effect-site concentration (Ce) of remifentanil in 50 % of patients (EC50) for successful insertion of the i-gel second-generation supraglottic airway device with that for laryngeal mask airway (LMA) insertion during target-controlled infusion (TCI) of propofol.

METHODS

Forty-one female patients were randomized to the i-gel group (n = 20) or the LMA group (n = 21). Anesthesia was induced with propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and the i-gel or LMA was inserted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient's response to device insertion was classified as either "success (no movement)" or "failure (movement)".

RESULTS

Using the Dixon's up-and-down method, EC50 of remifentanil Ce for the i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p = 0.038). Using isotonic regression, EC50 (83 % CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95 % CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml].

CONCLUSIONS

We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml) in female patients during propofol TCI without neuromuscular blockade.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University, Incheon, Korea.Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University, Incheon, Korea.Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea.Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea.Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea. kjyeop@ajou.ac.kr.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26758073

Citation

Choi, Jong Bum, et al. "Comparison of Remifentanil EC50 for Facilitating I-gel and Laryngeal Mask Airway Insertion With Propofol Anesthesia." Journal of Anesthesia, vol. 30, no. 3, 2016, pp. 377-83.
Choi JB, Kwak HJ, Lee KC, et al. Comparison of remifentanil EC50 for facilitating i-gel and laryngeal mask airway insertion with propofol anesthesia. J Anesth. 2016;30(3):377-83.
Choi, J. B., Kwak, H. J., Lee, K. C., Lee, S. R., Lee, S. Y., & Kim, J. Y. (2016). Comparison of remifentanil EC50 for facilitating i-gel and laryngeal mask airway insertion with propofol anesthesia. Journal of Anesthesia, 30(3), 377-83. https://doi.org/10.1007/s00540-015-2133-6
Choi JB, et al. Comparison of Remifentanil EC50 for Facilitating I-gel and Laryngeal Mask Airway Insertion With Propofol Anesthesia. J Anesth. 2016;30(3):377-83. PubMed PMID: 26758073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of remifentanil EC50 for facilitating i-gel and laryngeal mask airway insertion with propofol anesthesia. AU - Choi,Jong Bum, AU - Kwak,Hyun Jeong, AU - Lee,Kyung Cheon, AU - Lee,Se Ryeon, AU - Lee,Sook Young, AU - Kim,Jong Yeop, Y1 - 2016/01/13/ PY - 2015/11/09/received PY - 2015/12/24/accepted PY - 2016/1/14/entrez PY - 2016/1/14/pubmed PY - 2017/2/12/medline KW - Laryngeal mask airway KW - Remifentanil KW - i-gel SP - 377 EP - 83 JF - Journal of anesthesia JO - J Anesth VL - 30 IS - 3 N2 - OBJECTIVE: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to compare the effect-site concentration (Ce) of remifentanil in 50 % of patients (EC50) for successful insertion of the i-gel second-generation supraglottic airway device with that for laryngeal mask airway (LMA) insertion during target-controlled infusion (TCI) of propofol. METHODS: Forty-one female patients were randomized to the i-gel group (n = 20) or the LMA group (n = 21). Anesthesia was induced with propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and the i-gel or LMA was inserted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient's response to device insertion was classified as either "success (no movement)" or "failure (movement)". RESULTS: Using the Dixon's up-and-down method, EC50 of remifentanil Ce for the i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p = 0.038). Using isotonic regression, EC50 (83 % CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95 % CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. CONCLUSIONS: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml) in female patients during propofol TCI without neuromuscular blockade. SN - 1438-8359 UR - https://www.unboundmedicine.com/medline/citation/26758073/Comparison_of_remifentanil_EC50_for_facilitating_i_gel_and_laryngeal_mask_airway_insertion_with_propofol_anesthesia_ L2 - https://dx.doi.org/10.1007/s00540-015-2133-6 DB - PRIME DP - Unbound Medicine ER -