Tags

Type your tag names separated by a space and hit enter

Effect of sex differences in remifentanil requirements for the insertion of a laryngeal mask airway during propofol anesthesia: A prospective randomized trial.
Medicine (Baltimore). 2016 Sep; 95(39):e5032.M

Abstract

BACKGROUND

Remifentanil can improve insertion of a laryngeal mask airway (LMA) during induction with propofol. Recently, it has been suggested that there is a sex difference in opioid requirements for this procedure. The purposes of this study were to determine the effective effect-site concentration (Ce) of remifentanil for the facilitation of LMA insertion in male and female patients during propofol anesthesia without neuromuscular blockade and to evaluate whether there are sex differences in the Ce of remifentanil required for successful LMA insertion.

METHODS

Forty-eight patients (24 male, 24 female) with American Society of Anesthesiologists physical status 1 or 2, aged 20 to 60 years, scheduled for minor orthopedic surgery under general anesthesia were enrolled. Anesthesia was induced by target-controlled infusion (TCI) of propofol and remifentanil. The target Ce of propofol was 5 μg/mL initially and was reduced to 3.5 μg/mL after loss of consciousness. The Ce of remifentanil given to each patient was determined by the response of the previously tested patient using 0.5 ng/mL as a step size. The 1st patient was tested at a Ce of 3.0 ng/mL of remifentanil. Successful LMA insertion was defined as smooth insertion without patient movement or significant resistance to mouth opening.

RESULTS

The effective Ce of remifentanil required for successful LMA insertion on 50% of occasions (effective effect-site concentration for 50% [EC50]) as estimated by Dixon method was significantly lower in women (2.18 ± 0.35 ng/mL) than in men (2.82 ± 0.53 ng/mL) (P = 0.02). Using the isotonic regression method, the effective Ce of remifentanil required for successful LMA insertion on 95% of occasions (EC95) (95% confidence interval [CI]) was significantly lower in women (3.38 [3.0-3.48] ng/mL) than in men (3.94 [3.80-3.98] ng/mL).

CONCLUSION

The Ce of remifentanil required to facilitate successful LMA insertion is higher during propofol induction by TCI in men than in women. When using remifentanil for LMA insertion, patient sex should be taken into account for appropriate dosing.

Authors+Show Affiliations

aDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, World Cup-ro, Yeongtong-gu, Suwon bDepartment of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Namdong-gu, Incheon, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27684878

Citation

Joe, Han Bum, et al. "Effect of Sex Differences in Remifentanil Requirements for the Insertion of a Laryngeal Mask Airway During Propofol Anesthesia: a Prospective Randomized Trial." Medicine, vol. 95, no. 39, 2016, pp. e5032.
Joe HB, Kim JY, Kwak HJ, et al. Effect of sex differences in remifentanil requirements for the insertion of a laryngeal mask airway during propofol anesthesia: A prospective randomized trial. Medicine (Baltimore). 2016;95(39):e5032.
Joe, H. B., Kim, J. Y., Kwak, H. J., Oh, S. E., Lee, S. Y., & Park, S. Y. (2016). Effect of sex differences in remifentanil requirements for the insertion of a laryngeal mask airway during propofol anesthesia: A prospective randomized trial. Medicine, 95(39), e5032. https://doi.org/10.1097/MD.0000000000005032
Joe HB, et al. Effect of Sex Differences in Remifentanil Requirements for the Insertion of a Laryngeal Mask Airway During Propofol Anesthesia: a Prospective Randomized Trial. Medicine (Baltimore). 2016;95(39):e5032. PubMed PMID: 27684878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of sex differences in remifentanil requirements for the insertion of a laryngeal mask airway during propofol anesthesia: A prospective randomized trial. AU - Joe,Han Bum, AU - Kim,Jong Yeop, AU - Kwak,Hyun Jeong, AU - Oh,Sang Eon, AU - Lee,Sook Young, AU - Park,Sung Yong, PY - 2016/9/30/entrez PY - 2016/9/30/pubmed PY - 2017/2/12/medline SP - e5032 EP - e5032 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 39 N2 - BACKGROUND: Remifentanil can improve insertion of a laryngeal mask airway (LMA) during induction with propofol. Recently, it has been suggested that there is a sex difference in opioid requirements for this procedure. The purposes of this study were to determine the effective effect-site concentration (Ce) of remifentanil for the facilitation of LMA insertion in male and female patients during propofol anesthesia without neuromuscular blockade and to evaluate whether there are sex differences in the Ce of remifentanil required for successful LMA insertion. METHODS: Forty-eight patients (24 male, 24 female) with American Society of Anesthesiologists physical status 1 or 2, aged 20 to 60 years, scheduled for minor orthopedic surgery under general anesthesia were enrolled. Anesthesia was induced by target-controlled infusion (TCI) of propofol and remifentanil. The target Ce of propofol was 5 μg/mL initially and was reduced to 3.5 μg/mL after loss of consciousness. The Ce of remifentanil given to each patient was determined by the response of the previously tested patient using 0.5 ng/mL as a step size. The 1st patient was tested at a Ce of 3.0 ng/mL of remifentanil. Successful LMA insertion was defined as smooth insertion without patient movement or significant resistance to mouth opening. RESULTS: The effective Ce of remifentanil required for successful LMA insertion on 50% of occasions (effective effect-site concentration for 50% [EC50]) as estimated by Dixon method was significantly lower in women (2.18 ± 0.35 ng/mL) than in men (2.82 ± 0.53 ng/mL) (P = 0.02). Using the isotonic regression method, the effective Ce of remifentanil required for successful LMA insertion on 95% of occasions (EC95) (95% confidence interval [CI]) was significantly lower in women (3.38 [3.0-3.48] ng/mL) than in men (3.94 [3.80-3.98] ng/mL). CONCLUSION: The Ce of remifentanil required to facilitate successful LMA insertion is higher during propofol induction by TCI in men than in women. When using remifentanil for LMA insertion, patient sex should be taken into account for appropriate dosing. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/27684878/Effect_of_sex_differences_in_remifentanil_requirements_for_the_insertion_of_a_laryngeal_mask_airway_during_propofol_anesthesia:_A_prospective_randomized_trial_ L2 - https://doi.org/10.1097/MD.0000000000005032 DB - PRIME DP - Unbound Medicine ER -