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KMID : 1155520070020010014
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Anesthesia and Pain Medicine
2007 Volume.2 No. 1 p.14 ~ p.21
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Effects of Dosages of Remifentanil Calculated by Total Body Weight and Ideal Body Weight to Intubation Circumstances and Adverse Hemodynamic Responses
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Kim Shin-Sung
Kim Young-Taek
Park Byung-Soon
Lee Byung-Jun
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Abstract
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Background: Remifentanil presents good intubation conditions and blunting adverse hemodynamic responses following intubation.So, we evaluated to determine optimal dosage of remifentanil for intubation which consider ideal body weight.
Methods: 160 ASA class 1?2 patients were selected and divided 4 groups, which were composed of 40 patients.Group 1 and 2 were administrated dosage calculated by TBW (total body weight).Each group was administrated intravenous continuous infusion dose of 1.0 ug/kg/min of remifentanil during 2 minutes followed by intravenous bolus dose of 2 mg/kg of propofol (Group 1) and 2.0 ug/kg/min of remifentanil followed by same dose of propofol (Group 2).Group 3 and 4 were administerated same dosage of Group 1 and 2 but administrated dosage calculated by IBW (ideal body weight).We didn’t use any muscle relaxant. Intubation conditions and postintubation hemodynamic responses were assessed by 5 items based on GCRP (good clinical research practice), MAP (mean arterial pressure) and HR (heart rate).
Results:We have done intubation safely 60, 75, 55 and 98% of Group 1, 2, 3 and 4 respectively.Group 1, 3 have ’technically unacceptable’ cases, but group 2, 4 have ’clinically unacceptable’ cases. Hemodynamic responses of Group 4 were more stable than Group 2, especially obese patients.Obese patients present a problem for the appropriate dosing of remifentanil and profound hypotension and/or bradycardia developed more frequently when administerated agent calculated by total body weight.
Conclusions: The optimal dosage which produce best intubation conditions and least side effects has to be determined according to IBW. (Anesth Pain Med 2007; 2: 14∼21)
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KEYWORD
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ideal body weight, intubating conditions, obesity, propofol, remifentanil.
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