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KMID : 0356920090560040392
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Korean Journal of Anesthesiology
2009 Volume.56 No. 4 p.392 ~ p.397
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What is the optimal effect-site concentration of remifentanil for minimizing the cardiovascular changes to endotracheal intubation during induction with propofol in elderly patients?
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Tak Yang-Ju
Shin Hyun-Jung
Kim Eun-Seok
Koo Bon-Wook
Shin Young-Duck
Kim Sang-Tae
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Abstract
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Background: The addition of remifentanil during propofol TCI (target controlled infusion) attenuates the hemodynamic changes induced by endotracheal intubation. This study examined the optimal effect-site concentration of remifentanil to minimize the cardiovascular changes to endotracheal intubation in elderly patients.
Methods: Fifty ASA 1 or 2 elderly patients scheduled for elective surgery under general anesthesia were assigned randomly to one of two groups according to the effect-site concentration of remifentanil. Each group was administered 4?g/ml of propofol TCI with 1 ng/ml (group R1) or 3 ng/ml (group R3) of remifentanil. The heart rate (HR), systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP) were measured at pre-induction, before and after endotracheal intubation.
Results: After intubation, the HR, SAP, MAP and DAP increased significantly in the two groups compared with the pre-intubation values. However, the HR, SAP, MAP and DAP for group R3 were lower than group R1 for 5 min after intubation.
Conclusions: In elderly patients administered 4?g/ml of propofol TCI, we suggest that the optimal effect-site concentration of remifentanil to minimize the cardiovascular changes to endotracheal intubation is 3 ng/ml rather than 1 ng/ml.
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KEYWORD
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Cardiovascular changes, Effect-site concentration, Elderly patient, Intubation, Propofol, Remifentanil
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