Korean J Anesthesiol.  2009 Apr;56(4):392-397. 10.4097/kjae.2009.56.4.392.

What is the optimal effect-site concentration of remifentanil for minimizing the cardiovascular changes to endotracheal intubation during induction with propofol in elderly patients?

• Tak YJ
• Shin HJ
• Kim ES
• Koo BW
• Shin YD
• Kim ST

• KMID: 2236524
• DOI: http://doi.org/10.4097/kjae.2009.56.4.392

Abstract

BACKGROUND
The addition of remifentanil during propofol TCI (target controlled infusion) attenuates the hemodynamic changes induced by endotracheal intubation. This study examined the optimal effect-site concentration of remifentanil to minimize the cardiovascular changes to endotracheal intubation in elderly patients. METHODS: Fifty ASA 1 or 2 elderly patients scheduled for elective surgery under general anesthesia were assigned randomly to one of two groups according to the effect-site concentration of remifentanil. Each group was administered 4 microgram/ml of propofol TCI with 1 ng/ml (group R1) or 3 ng/ml (group R3) of remifentanil. The heart rate (HR), systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP) were measured at pre-induction, before and after endotracheal intubation. RESULTS: After intubation, the HR, SAP, MAP and DAP increased significantly in the two groups compared with the pre-intubation values. However, the HR, SAP, MAP and DAP for group R3 were lower than group R1 for 5 min after intubation. CONCLUSIONS: In elderly patients administered 4 microg/ml of propofol TCI, we suggest that the optimal effect-site concentration of remifentanil to minimize the cardiovascular changes to endotracheal intubation is 3 ng/ml rather than 1 ng/ml.

Keyword

Cardiovascular changes; Effect-site concentration; Elderly patient; Intubation; Propofol; Remifentanil

MeSH Terms

Aged
Anesthesia, General
Arterial Pressure
Heart Rate
Hemodynamics
Humans
Intubation
Intubation, Intratracheal
Piperidines
Propofol
Piperidines
Propofol