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Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial

BACKGROUND: A new supraglottic device, the LMA-Supreme™, has recently become available for clinical use. Information on anaesthetic and co-adjuvant requirements for insertion of the LMA-Supreme™ is limited. The present study aimed to evaluate the optimal effect-site concentration of propofol in 50 %...

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Autores principales: Zaballos, Matilde, Bastida, Emilia, Agustí, Salomé, Portas, Maite, Jiménez, Consuelo, López-Gil, Maite
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595052/
https://www.ncbi.nlm.nih.gov/pubmed/26438179
http://dx.doi.org/10.1186/s12871-015-0115-8
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author Zaballos, Matilde
Bastida, Emilia
Agustí, Salomé
Portas, Maite
Jiménez, Consuelo
López-Gil, Maite
author_facet Zaballos, Matilde
Bastida, Emilia
Agustí, Salomé
Portas, Maite
Jiménez, Consuelo
López-Gil, Maite
author_sort Zaballos, Matilde
collection PubMed
description BACKGROUND: A new supraglottic device, the LMA-Supreme™, has recently become available for clinical use. Information on anaesthetic and co-adjuvant requirements for insertion of the LMA-Supreme™ is limited. The present study aimed to evaluate the optimal effect-site concentration of propofol in 50 % (EC(50)) of adults necessary for successful insertion of the LMA-Supreme™ and to examine remifentanil’s effect on propofol requirements. METHODS: Fifty-eight elective patients (aged 18–60 years; ASA (American Society Anaesthesiologists) physical status classification I and II) scheduled for day surgery were randomly assigned to one of two groups: propofol with saline or propofol with remifentanil. Anaesthesia was induced by target-controlled infusion according to predetermined effect-site concentrations of propofol and remifentanil (5 ng.mL(−1)). The EC(50) was calculated using Dixon’s up-and-down method. Ten minutes following drug administration, LMA-Supreme™ insertion was attempted without the use of muscle relaxant drugs. RESULTS: In the propofol + saline group, the EC(50) of propofol required for LMA-Supreme™ insertion was 6.32 ± 0.67 μg.mL(−1) (95 % CI, 5.69–6.94 μg.mL(−1)). With the addition of remifentanil at an effect-site concentration of 5 ng.mL(−1), the EC(50) of propofol required for LMA-Supreme™ insertion was 2.50 ± 0.80 μg.mL(−1) (95 % CI, 1.82–3.17 μg.mL(−1); p < 0.0001). CONCLUSIONS: The propofol requirement for smooth insertion of the LMA-Supreme™ was 60 % less when remifentanil (5 ng.mL(−1)) was co-administered. CLINICAL TRIAL REGISTRATION: Identified as NCT01974648 at www.clinicaltrials.gov.
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spelling pubmed-45950522015-10-07 Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial Zaballos, Matilde Bastida, Emilia Agustí, Salomé Portas, Maite Jiménez, Consuelo López-Gil, Maite BMC Anesthesiol Research Article BACKGROUND: A new supraglottic device, the LMA-Supreme™, has recently become available for clinical use. Information on anaesthetic and co-adjuvant requirements for insertion of the LMA-Supreme™ is limited. The present study aimed to evaluate the optimal effect-site concentration of propofol in 50 % (EC(50)) of adults necessary for successful insertion of the LMA-Supreme™ and to examine remifentanil’s effect on propofol requirements. METHODS: Fifty-eight elective patients (aged 18–60 years; ASA (American Society Anaesthesiologists) physical status classification I and II) scheduled for day surgery were randomly assigned to one of two groups: propofol with saline or propofol with remifentanil. Anaesthesia was induced by target-controlled infusion according to predetermined effect-site concentrations of propofol and remifentanil (5 ng.mL(−1)). The EC(50) was calculated using Dixon’s up-and-down method. Ten minutes following drug administration, LMA-Supreme™ insertion was attempted without the use of muscle relaxant drugs. RESULTS: In the propofol + saline group, the EC(50) of propofol required for LMA-Supreme™ insertion was 6.32 ± 0.67 μg.mL(−1) (95 % CI, 5.69–6.94 μg.mL(−1)). With the addition of remifentanil at an effect-site concentration of 5 ng.mL(−1), the EC(50) of propofol required for LMA-Supreme™ insertion was 2.50 ± 0.80 μg.mL(−1) (95 % CI, 1.82–3.17 μg.mL(−1); p < 0.0001). CONCLUSIONS: The propofol requirement for smooth insertion of the LMA-Supreme™ was 60 % less when remifentanil (5 ng.mL(−1)) was co-administered. CLINICAL TRIAL REGISTRATION: Identified as NCT01974648 at www.clinicaltrials.gov. BioMed Central 2015-10-06 /pmc/articles/PMC4595052/ /pubmed/26438179 http://dx.doi.org/10.1186/s12871-015-0115-8 Text en © Zaballos et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zaballos, Matilde
Bastida, Emilia
Agustí, Salomé
Portas, Maite
Jiménez, Consuelo
López-Gil, Maite
Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title_full Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title_fullStr Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title_full_unstemmed Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title_short Effect-site concentration of propofol required for LMA-Supreme™ insertion with and without remifentanil: a randomized controlled trial
title_sort effect-site concentration of propofol required for lma-supreme™ insertion with and without remifentanil: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595052/
https://www.ncbi.nlm.nih.gov/pubmed/26438179
http://dx.doi.org/10.1186/s12871-015-0115-8
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