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Comparison of effect-site concentration of remifentanil for tracheal intubation with the lightwand and laryngoscopy during propofol target-controlled infusion

Authors
Kim, JS; Kim, DH; Min, SK; Kim, KM; Kim, JY
Citation
Korean journal of anesthesiology, 60(6):393-397, 2011
Journal Title
Korean journal of anesthesiology
ISSN
2005-64192005-7563
Abstract
Background: Target-controlled infusion (TCI) of propofol and remifentanil can provide satisfactory intubating conditions without a neuromuscular blocking agent. We compared the effect-site concentration of remifentanil required for intubation with the lightwand and the Macintosh laryngoscope during propofol TCI without a neuromuscular blocking agent in adult patients.



Methods: Forty-nine patients were randomly assigned to the lightwand group (n = 25) or the direct laryngoscope group (n = 24). Anesthesia was induced by propofol TCI with an effect-site concentration of 5.4 μg/ml. Two minutes after start of propofol TCI, remifentanil was administered at the predetermined effect-site concentration. The effect-site concentration of remifentanil was determined using Dixon’s up-and-down method (0.5 ng/ml as a step size). The first patient in each group was tested at 4.5 ng/ml of remifentanil. Tracheal intubation was performed 2 min after the start of remifentanil TCI. Acceptable intubation was defined as an excellent or good intubating conditions.



Results: Using a modified Dixon’s up and down method, the EC50 ± SD of remifentanil in the lightwand and laryngoscope groups was 4.75 ± 0.71 ng/ml and 5.08 ± 0.52 ng/ml, respectively; there was no statistically significant difference between the groups (P = 0.373).



Conclusions: The effect-site concentration of remifentanil for acceptable intubation with the lightwand and Macintosh laryngoscope in 50% of adults did not differ during propofol TCI without a neuromuscular blocking agent.
Keywords
IntubationLightwandPropofolRemifentanilTarget-controlled infusion
DOI
10.4097/kjae.2011.60.6.393
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
김, 진수김, 대희민, 상기김, 종엽
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