Optimal effect-site concentration of remifentanil for minimizing cardiovascular changes caused by fiberoptic nasotracheal intubation
| العنوان: | Optimal effect-site concentration of remifentanil for minimizing cardiovascular changes caused by fiberoptic nasotracheal intubation |
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| المؤلفون: | Ji Young Yoon, Ji Uk Yoon, Seung-Hoon Baek, Tae Kyun Kim, Eun-Jung Kim, Hyun Wook Jeon |
| المصدر: | Journal of Dental Anesthesia and Pain Medicine |
| بيانات النشر: | The Korean Dental Society of Anesthesiology, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, medicine.medical_treatment, Remifentanil, Hemodynamics, Surgery, Blood pressure, Mean blood pressure, Anesthesia, Heart rate, medicine, Intubation, Original Article, Nasotracheal intubation, Rocuronium, Propofol, business, medicine.drug |
| الوصف: | Background: Endotracheal intubation induces clinically adverse cardiovascular changes. Various pharmacological strategies for controlling these responses have been suggested with opioids being widely administered. In this study, the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses to fiberoptic nasotracheal intubation was evaluated. Methods: Thirty patients, aged 18–63 years, scheduled for elective surgery were included. Anesthesia was induced with a propofol and remifentanil infusion via target-controlled infusion (TCI). Remifentanil infusion was initiated at 3.0 ng/mL, and the response of each patient determined the Ce of remifentanil for the next patient by the Dixon up-and-down method at an interval of 0.5 ng/mL. Rocuronium was administered after propofol and remifentanil reached their preset Ce; 90 seconds later fiberoptic nasotracheal intubation was initiated. Non-invasive blood pressure and heart rate (HR) were measured at pre-induction, the time Ce was reached, immediately before and after intubation, and at 1 and 3 minutes after intubation. The up-and-down criteria comprised a 20% change in mean blood pressure and HR between just prior to intubation and 1 minute after intubation. Results: The median effective effect-site concentration (EC50) of remifentanil was 3.11 ± 0.38 ng/mL by the Dixon's up-and-down method. From the probit analysis, the EC50 of remifentanil was 3.43 ng/mL (95% confidence interval, 2.90–4.06 ng/mL). In PAVA, the EC50 and EC95 of remifentanil were 3.57 ng/mL (95% CI, 2.95–3.89) and 4.35 ng/mL (95% CI, 3.93–4.45). No remifentanil-related complications were observed. Conclusions: The EC50 of remifentanil for minimizing the cardiovascular changes and side effects associated with fiberoptic nasotracheal intubation was 3.11–3.43 ng/mL during propofol TCI anesthesia with a Ce of 4 ug/mL. |
| تدمد: | 2383-9317 2383-9309 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f03a64a04a6cddf3e146a0253281bb6aTest https://doi.org/10.17245/jdapm.2015.15.4.221Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f03a64a04a6cddf3e146a0253281bb6a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 23839317 23839309 |
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