Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia

BACKGROUND: Transillumination using a light wand is an alternative type of laryngoscope used for tracheal intubation. There is little information available on the effect-site concentration of remifentanil required to control hemodynamic changes induced by tracheal intubation using the transilluminat...

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Autores principales: Yon, Jun Heum, Jo, Jae Keun, Kwon, Young-Suk, Park, Hae-Gyun, Lee, Sangseok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Anesthesiologists 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121085/
https://www.ncbi.nlm.nih.gov/pubmed/21738841
http://dx.doi.org/10.4097/kjae.2011.60.6.398
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author Yon, Jun Heum
Jo, Jae Keun
Kwon, Young-Suk
Park, Hae-Gyun
Lee, Sangseok
author_facet Yon, Jun Heum
Jo, Jae Keun
Kwon, Young-Suk
Park, Hae-Gyun
Lee, Sangseok
author_sort Yon, Jun Heum
collection PubMed
description BACKGROUND: Transillumination using a light wand is an alternative type of laryngoscope used for tracheal intubation. There is little information available on the effect-site concentration of remifentanil required to control hemodynamic changes induced by tracheal intubation using the transillumination method during total IV anesthesia. We therefore conducted this study to determine the effect-site concentration of remifentanil blunting hemodynamic responses after tracheal intubation in patients receiving propofol anesthesia. METHODS: We enrolled 26 healthy adult patients (ASA physical status I-II), aged 16-67 scheduled for surgery within 2 hours. All patients received a target-controlled infusion of 4 µg/ml propofol. The effect-site target-concentration of remifentanil of 5.0 ng/ml was chosen for the first patient. We used the Dixon's up-and-down sequential allocation method for determining the next remifentanil concentration. The time required for tracheal intubation was measured as the level of intubation stimulation. RESULTS: The average intubation time was 13.9 ± 9.1 seconds. From the Dixon's method, the EC(50) of remifentanil blunting the hemodynamic response to tracheal intubation was 2.94 ng/ml. CONCLUSIONS: This study shows that effect-site concentrations of remifentanil of 2.94 ng/ml is effective in blunting sympathetic responses to tracheal intubation in 50% of patients with normal airway anatomy when combined with a target controlled infusion of propofol (4 µg/ml).
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spelling pubmed-31210852011-07-07 Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia Yon, Jun Heum Jo, Jae Keun Kwon, Young-Suk Park, Hae-Gyun Lee, Sangseok Korean J Anesthesiol Clinical Research Article BACKGROUND: Transillumination using a light wand is an alternative type of laryngoscope used for tracheal intubation. There is little information available on the effect-site concentration of remifentanil required to control hemodynamic changes induced by tracheal intubation using the transillumination method during total IV anesthesia. We therefore conducted this study to determine the effect-site concentration of remifentanil blunting hemodynamic responses after tracheal intubation in patients receiving propofol anesthesia. METHODS: We enrolled 26 healthy adult patients (ASA physical status I-II), aged 16-67 scheduled for surgery within 2 hours. All patients received a target-controlled infusion of 4 µg/ml propofol. The effect-site target-concentration of remifentanil of 5.0 ng/ml was chosen for the first patient. We used the Dixon's up-and-down sequential allocation method for determining the next remifentanil concentration. The time required for tracheal intubation was measured as the level of intubation stimulation. RESULTS: The average intubation time was 13.9 ± 9.1 seconds. From the Dixon's method, the EC(50) of remifentanil blunting the hemodynamic response to tracheal intubation was 2.94 ng/ml. CONCLUSIONS: This study shows that effect-site concentrations of remifentanil of 2.94 ng/ml is effective in blunting sympathetic responses to tracheal intubation in 50% of patients with normal airway anatomy when combined with a target controlled infusion of propofol (4 µg/ml). The Korean Society of Anesthesiologists 2011-06 2011-06-17 /pmc/articles/PMC3121085/ /pubmed/21738841 http://dx.doi.org/10.4097/kjae.2011.60.6.398 Text en Copyright © the Korean Society of Anesthesiologists, 2011 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Yon, Jun Heum
Jo, Jae Keun
Kwon, Young-Suk
Park, Hae-Gyun
Lee, Sangseok
Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title_full Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title_fullStr Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title_full_unstemmed Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title_short Effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
title_sort effect-site concentration of remifentanil for blunting hemodynamic responses to tracheal intubation using light wand during target controlled infusion-total intravenous anesthesia
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121085/
https://www.ncbi.nlm.nih.gov/pubmed/21738841
http://dx.doi.org/10.4097/kjae.2011.60.6.398
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