Korean J Anesthesiol.  2014 Apr;66(4):278-282. 10.4097/kjae.2014.66.4.278.

Remifentanil dose for laryngeal mask airway insertion with a single standard dose of propofol during emergency airway management in elderly patients

• Ryu J
• Oh AY
• Baek JS
• Kim JH
• Park SH
• Noh JM

• KMID: 2236214
• DOI: http://doi.org/10.4097/kjae.2014.66.4.278

Abstract

BACKGROUND
This study determined the dose of remifentanil to use during insertion of a Classic(TM) laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol.
METHODS
Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient's loss of consciousness. The dose of remifentanil was determined using Dixon's up-and-down method, starting at 0.5 microg/kg (a step size of 0.1 microg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness.
RESULTS
In total, 23 patients were recruited and the mean age +/- standard deviation was 72 +/- 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 +/- 0.05 microg/kg. No patient needed more than 0.3 microg/kg.
CONCLUSIONS
Remifentanil 0.20 +/- 0.05 microg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.

Keyword

Aged; Laryngeal mask airway; Remifentanil

MeSH Terms

Aged*
Airway Management*
Anesthesia
Emergencies*
Hemodynamics
Humans
Laryngeal Masks*
Propofol*
Unconsciousness
Propofol