The Effects of Remifentanil on the LMA Insertion with the Administration of Propofol

Kim, Heung Ki; Choi, Seong Wook; Shin, Hye Won; Lee, Hye Won; Lim, Hae Ja; Yoon, Seok Min; Chang, Seong Ho

Abstract

BACKGROUND
Laryngeal mask airway (LMA) can be inserted without muscle relaxant in patients who have received propofol. Remifentanil that is recently used opioid effectively attenuates the hemodynamic responses to laryngoscopy. This study was to investigate the effects of remifentanil on the quality and hemodynamic response of LMA insertion after intravenous propofol induction without muscle relaxant.
METHODS
Forty patients (ASA I or II, 20-65 years) were randomly allocated to control and remifentanil group. Control group received propofol 4microg/ml alone, remifentanil group received propofol 4microg/ml and remifetanil 2 ng/ml by target controlled infusion. LMA insertion condition was assessed by Muzi's score (jaw mobility, coughing, movement). The time interval to loss of eyelash reflex, to BIS < 60 and to insertion of LMA were recorded. The BIS and hemodynamic changes were measured at preinduction (baseline), preinsertion and postinsertion.
RESULTS
Loss of consciousness and LMA insertion were more rapid with remifentanil group than control group (P < 0.05). Clinically acceptable insertion of LMA were observed in 35% and 70% of patients in the control and remifentanil group, respectively. There were significant elevations in heart rate, mean blood pressure after insertion of LMA in control group, but no elevations in remifentanil group. And there were no significant differences in BIS in both groups.
CONCLUSIONS
The LMA insertion with propofol-remifentanil can provide more favorable condition and stable hemodynamic status compared with propofol alone.