Korean J Anesthesiol.  2011 Jun;60(6):393-397. 10.4097/kjae.2011.60.6.393.

Comparison of effect-site concentration of remifentanil for tracheal intubation with the lightwand and laryngoscopy during propofol target-controlled infusion

• Kim JS
• Kim DH
• Min SK
• Kim KM
• Kim JY

• KMID: 1766651
• DOI: http://doi.org/10.4097/kjae.2011.60.6.393

Abstract

BACKGROUND
Target-controlled infusion (TCI) of propofol and remifentanil can provide satisfactory intubating conditions without a neuromuscular blocking agent. We compared the effect-site concentration of remifentanil required for intubation with the lightwand and the Macintosh laryngoscope during propofol TCI without a neuromuscular blocking agent in adult patients.
METHODS
Forty-nine patients were randomly assigned to the lightwand group (n = 25) or the direct laryngoscope group (n = 24). Anesthesia was induced by propofol TCI with an effect-site concentration of 5.4 microg/ml. Two minutes after start of propofol TCI, remifentanil was administered at the predetermined effect-site concentration. The effect-site concentration of remifentanil was determined using Dixon's up-and-down method (0.5 ng/ml as a step size). The first patient in each group was tested at 4.5 ng/ml of remifentanil. Tracheal intubation was performed 2 min after the start of remifentanil TCI. Acceptable intubation was defined as an excellent or good intubating conditions.
RESULTS
Using a modified Dixon's up and down method, the EC50 +/- SD of remifentanil in the lightwand and laryngoscope groups was 4.75 +/- 0.71 ng/ml and 5.08 +/- 0.52 ng/ml, respectively; there was no statistically significant difference between the groups (P = 0.373).
CONCLUSIONS
The effect-site concentration of remifentanil for acceptable intubation with the lightwand and Macintosh laryngoscope in 50% of adults did not differ during propofol TCI without a neuromuscular blocking agent.

Keyword

Intubation; Lightwand; Propofol; Remifentanil; Target-controlled infusion

MeSH Terms

Adult
Anesthesia
Humans
Intubation
Laryngoscopes
Laryngoscopy
Neuromuscular Blockade
Piperidines
Propofol
Piperidines
Propofol