Comparison of remifentanil EC50 for facilitating i-gel and laryngeal mask airway insertion with propofol anesthesia
- Authors
- Choi, Jong Bum; Kwak, Hyun Jeong; Lee, Kyung Cheon; Lee, Se Ryeon; Lee, Sook Young; Kim, Jong Yeop
- Issue Date
- Jun-2016
- Publisher
- SPRINGER JAPAN KK
- Keywords
- i-gel; Laryngeal mask airway; Remifentanil
- Citation
- JOURNAL OF ANESTHESIA, v.30, no.3, pp.377 - 383
- Journal Title
- JOURNAL OF ANESTHESIA
- Volume
- 30
- Number
- 3
- Start Page
- 377
- End Page
- 383
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/8239
- DOI
- 10.1007/s00540-015-2133-6
- ISSN
- 0913-8668
- Abstract
- Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to compare the effect-site concentration (Ce) of remifentanil in 50 % of patients (EC50) for successful insertion of the i-gel second-generation supraglottic airway device with that for laryngeal mask airway (LMA) insertion during target-controlled infusion (TCI) of propofol. Forty-one female patients were randomized to the i-gel group (n = 20) or the LMA group (n = 21). Anesthesia was induced with propofol Ce of 5 mu g/ml and the predetermined remifentanil Ce, and the i-gel or LMA was inserted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient's response to device insertion was classified as either "success (no movement)" or "failure (movement)". Using the Dixon's up-and-down method, EC50 of remifentanil Ce for the i-gel (1.58 +/- 0.41 ng/ml) was significantly lower than that for LMA (2.25 +/- 0.55 ng/ml) (p = 0.038). Using isotonic regression, EC50 (83 % CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95 % CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml) in female patients during propofol TCI without neuromuscular blockade.
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