Korean J Anesthesiol.  2006 Sep;51(3):312-317. 10.4097/kjae.2006.51.3.312.

The Effect-Site Concentration of Remifentanil for Prevention of Increase of Blood Pressure and Heart Rate to Tracheal Intubation during Propofol-Remifentanil Total Intravenous Anesthesia in Korean

• Shinn HK
• Lee HS
• Lee CS
• Chung CK
• Cha DC
• Kim HH
• Song JH

• KMID: 2237430
• DOI: http://doi.org/10.4097/kjae.2006.51.3.312

Abstract

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences.
METHODS
Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation.
RESULTS
The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups.
CONCLUSIONS
Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences.

Keyword

propofol; remifentanil; sex differences; target-controlled infusion (TCI); tracheal intubation

MeSH Terms

Anesthesia, General
Anesthesia, Intravenous*
Arterial Pressure
Blood Pressure*
Female
Heart Rate*
Heart*
Hemodynamics
Humans
Intubation*
Male
Propofol
Sex Characteristics
Propofol