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KMID : 0356920070520030278
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Korean Journal of Anesthesiology
2007 Volume.52 No. 3 p.278 ~ p.283
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What is an Optimal Effect Site Concentration of Remifentanil for Minimizing the Hemodynamic Change to Endotracheal Intubation using Light Wand?
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Lee Jeoung-Hyuk
Jeon Woo-Jae
Shim Jae-Hang
Cho Sang-Yoon
Yeom Jong-Hoon
Shin Woo-Jong
Kim Kyoung-Hun
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Abstract
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Background: In the previous studies, remifentanil reduces the hemodynamic change induced by endotracheal intubation. We studied the optimal effect site concentration of remifentanil for endotracheal intubation using light wand.
Methods: Sixty ASA 1 or 2 patients scheduled for elective surgery under general anesthesia were classified in three groups according to the TCI (target controlled infusion) dose of remifentanil. Each group was administered 4μg/ml of propofol TCI, rocuronium, with 2 ng/ml (group 1), 4 ng/ml (group 2), 6 ng/ml (group 3) of remifentanil TCI. Blood pressure, heart rate and bispectral index score were measured before induction, 3 minutes after remifentanil and propofol TCI, after endotracheal intubation using light wand, and 3 minutes after endotracheal intubation. Statistical analysis was done for comparison of time and dose dependant change among the groups.
Results: After endotrachal intubation, blood pressure and heart rate were significantly increased in group 1, and decreased in group 2 and 3. 3 minute after endotracheal intubation, heart rate significantly decreased in group 3, but there were no changes in group 2.
Conclusion: The spontaneous BRS was decreased during ketamine induction of general anesthesia. These results suggest that anesthesia induction with ketamine impairs baroreflex control of heart rate, which may provoke hemodynamic instability.
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KEYWORD
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intubation, light wand, propofol, remifentanil, target controlled infusion
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