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Hemodynamic Responses according to Different Effect Site Concentration of Remifentanil during Endotracheal Intubation

Other Title
기관내삽관시 Remifentanil의 효과처농도에 따른 혈역학 변화
Authors
박, 관식; 김, 종엽; 채, 윤정; 민, 상기; 문, 봉기
Citation
Intravenous anesthesia, 9(4):191-196, 2005
Journal Title
Intravenous anesthesia; 정맥마취
ISSN
1226-4857
Abstract
Background: We evaluated the hemodynamic responses to laryngoscopy and tracheal intubation using a different effect site concentration of remifentanil when propofol was maintained at the effect site concentration of 5.4mug/ml.



Methods: Sixty patients presenting for elective surgery were randomly assigned to one of three groups according to target effect site concentration of remifentanil. Anesthesia was induced using a target effect site controlled infusion of propofol at a concentration of 5.4mug/ml. In all patients, remifentanil target controlled infusion (TCI) was started at the same time with a target effect site concentration of 0 (control group), 2 (group R2), or 4 ng/ml (group R4). Neuromuscular blockade was provided with rocuronium 0.6 mg/kg. The trachea was intubated under direct laryngoscopy 5 min after induction. Noninvasive arterial blood pressure and heart rate (HR) were recorded at 1 min interval from before induction of anesthesia until 3 min after intubation.



Results: Mean arterial pressure (MAP) and HR in the control group significantly increased at 1 min after intubation (P< 0.05). MAP in group R2 and R4 significantly decreased from 2 min after induction (P<0.05), but MAP in R4 group remained significantly decreased throughout 3 min after intubation, and were lower than the control group (P <0.05).



Conclusions: Effect site concentration of remifentanil at 2 ng/ml administered with propofol TCI at level of 5.4mug/ml attenuates the pressor response to endotracheal intubation, but effect site concentration of remifentanil at 4 ng/ml causes a significant hemodynamic compromise.
Keywords
intubationpropofolremifentaniltarget controlled infusion
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Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
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