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KMID : 0980320180180050295
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Journal of Dental Anesthesia and Pain Medicine
2018 Volume.18 No. 5 p.295 ~ p.300
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Optimal effective-site concentration of remifentanil for sedation during plate removal of maxilla
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Park Jeong-Hoon
Yoon Ji-Young
Kim Eun-Jung
Yoon Ji-Uk
Choi Byung-Moon
Ahn Ji-Hye
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Abstract
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Background: Removal of the plate following Le Fort I osteotomy and BSSO (bilateral sagittal split osteotomy) is a common procedure. However, patients who undergo plate removal experience intense pain and discomfort. This study investigated the half-maximal effective concentration (Ce50) of remifentanil in the prevention of plate removal pain under sedation using dexmedetomidine.
Methods: The study evaluated 18 patients, between 18 and 35 years of age, scheduled for elective surgery. Remifentanil infusion was initiated after sedation using dexmedetomidine, and started at a dose of 1.5 ng/mL on the first patient via target-controlled infusion (TCI). Patients received a loading dose of 1.0 μg/kg dexmedetomidine over 10 min, followed by a maintenance dose of 0.7 μg/kg/h. When the surgeon removed the plate, the patient Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score was observed.
Results: The Ce of remifentanil ranged from 0.9 to 2.1 ng/mL for the patients evaluated. The estimated effect-site concentrations of remifentanil associated with a 50% and 95% probability of reaching MOAA/S score of 3 were 1.28 and 2.51 ng/mL, respectively.
Conclusions: Plate removal of maxilla can be successfully performed without any pain or adverse effects by using the optimal remifentanil effect-site concentration (Ce50, 1.28 ng/mL; Ce95, 2.51 ng/mL) combined with sedation using dexmedetomidine.
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KEYWORD
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Conscious Sedation, Dexmedetomidine, Plate Removal, Remifentanil
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