Anesth Pain Med.  2017 Jul;12(3):247-250. 10.17085/apm.2017.12.3.247.

The effect-site concentration of remifentanil for blunting hemodynamic responses: comparative study in single-lumen endotracheal and double-lumen endobronchial intubation

• Park SK
• Kim HJ

• KMID: 2388841
• DOI: http://doi.org/10.17085/apm.2017.12.3.247

Abstract

BACKGROUND
This study undertook to compare the effect-site concentration of remifentanil for prevention of hemodynamic responses to endotracheal intubation, employing the single-lumen tracheal tube and the double-lumen bronchial tube during total intravenous anesthesia.
METHODS
Based on the nature of the surgery, 38 patients undergoing general anesthesia were assigned either to the single-lumen tube group or the double-lumen tube group. Anesthesia was induced by a target controlled infusion of propofol, with an effect-site concentration of 4 µg/ml. Remifentanil was then administered to the first patient in each group, with an effect-site concentration of 3.5 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to intubation, based on the up-and-down method.
RESULTS
The effect-site concentrations of remifentanil for prevention of hemodynamic responses to endotracheal intubation in 50% of patients (ECâ‚…â‚€) were 2.8 ng/ml (95% CI, 2.0-3.7 ng/ml) in the single-lumen tube group, and 2.9 ng/ml (95% CI, 2.5-3.2 ng/ml) in the double-lumen tube group. No significant difference was observed between the two groups.
CONCLUSIONS
The effect-site concentration of remifentanil for prevention of hemodynamic responses to endotracheal intubation did not differ during total intravenous anesthesia, using either the single-lumen tracheal tube or the double-lumen bronchial tube.

Keyword

Endotracheal anesthesia; Intubation; Remifentanil

MeSH Terms

Anesthesia
Anesthesia, Endotracheal
Anesthesia, General
Anesthesia, Intravenous
Hemodynamics*
Humans
Intubation*
Intubation, Intratracheal
Methods
Propofol
Propofol

Figure

• 

  Fig. 1 Individual hemodynamic responses to endotracheal intubation according to up-and-down method in patients using a single-lumen tracheal tube (A) and a double-lumen bronchial tube (B). The effect-site concentrations of remifentanil for prevention of hemodynamic responses to endotracheal intubation in 50% of patients (EC50) were 2.8 ng/ml (95% CI, 2.0–3.7 ng/ml) in the single-lumen tube group and 2.9 ng/ml (95% CI, 2.5–3.2 ng/ml) in the double-lumen tube group, which were not different between two groups.

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