Korean J Anesthesiol.  2011 Jan;60(1):8-11. 10.4097/kjae.2011.60.1.8.

Optimal effect-site concentration of remifentanil for preventing development of hypertension during tracheal intubation with inhaled desflurane induction

• Kim KO
• Chung S
• Chang EJ
• Lee Y

• KMID: 1827991
• DOI: http://doi.org/10.4097/kjae.2011.60.1.8

Abstract

BACKGROUND
The aim of the present study was to determine the effect-site concentration of remifentanil needed to prevent haemodynamic instability during tracheal intubation with inhaled desflurane induction.
METHODS
One hundred American Society of Anesthesiologists I and II female patients were randomized to receive an effect-site concentration of remifentanil of 0, 1, 2, 3, or 4 ng/ml. Induction of anaesthesia was started with intravenous injection of propofol 2 mg/kg. Ninety seconds after the completion of propofol injection, rocuronium (0.8 mg/kg) and remifentanil were administered simultaneously with 3% desflurane inhalation. Tracheal intubation was attempted 150 sec after the commencement of remifentanil administration.
RESULTS
A probit model of remifentanil concentration was predictive of successful intubation without development of hypertension (P for goodness-of-fit = 0.419). The effect-site concentration of remifentanil needed to achieve successful intubation without development of hypertension in 95% of the patients was 3.3 ng/ml (95% confidence interval, 2.6-4.8 ng/ml).
CONCLUSIONS
The effect-site concentration of remifentanil of 3.3 ng/ml is effective in blunting the haemodynamic response in 95% of the patients when 2.0 mg/kg of propofol induction was followed by 3% desflurane inhalation.

Keyword

Desflurane; Intubation; Remifentanil effect-site concentration

MeSH Terms

Androstanols
Female
Humans
Hypertension
Inhalation
Injections, Intravenous
Intubation
Isoflurane
Piperidines
Propofol
Androstanols
Isoflurane
Piperidines
Propofol