Effective concentration of remifentanil for successful i-gel insertion during remimazolam inductionopen access레미마졸람을 이용한 전신마취 시 i-gel 삽입을 위한 레미펜타닐의 유효 농도
- Other Titles
- 레미마졸람을 이용한 전신마취 시 i-gel 삽입을 위한 레미펜타닐의 유효 농도
- Authors
- Choi, Jung Ju; Jung, Wol Seon; Chang, Young Jin; Yoo, Seungbeom; Kwak, Hyun Jeong
- Issue Date
- Jun-2023
- Publisher
- KOREAN SOC ANESTHESIOLOGISTS
- Keywords
- Airway management; General anesthesia; Intravenous anesthetics; Neuromus-cular blocking agents; Remifentanil; Remimazolam
- Citation
- KOREAN JOURNAL OF ANESTHESIOLOGY, v.76, no.3, pp.235 - 241
- Journal Title
- KOREAN JOURNAL OF ANESTHESIOLOGY
- Volume
- 76
- Number
- 3
- Start Page
- 235
- End Page
- 241
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88610
- DOI
- 10.4097/kja.22606
- ISSN
- 2005-6419
- Abstract
- Background: Remifentanil can be used as adjuvants during remimazolam induction with-out neuromuscular blockade. We evaluated the 95% effective concentration (EC) of remifentanil effect-site concentration (Ce) for the successful insertion of an i-gel using the biased-coin up-and-down method in adult patients during remimazolam induction.Methods: Forty 19-65 year-old patients scheduled to undergo surgery using i-gel were en-rolled. Anesthesia was induced using remimazolam infusion (12 mg/kg/h). Simultaneous-ly, remifentanil was infused at a predetermined Ce. After 5 min of anesthesia induction, the i-gel was inserted. The 95% EC (EC95) of remifentanil in each patient was determined using a biased-coin up-and-down method based on a successful insertion in a preceding patient. The step size of remifentanil Ce was 0.4 ng/ml. If the insertion failed, remifentanil Ce was increased in the next patient. Following successful insertions, the corresponding concentration decreased in subsequent patients with a probability of 1/19 or was main-tained with a probability of 18/19. The time from remimazolam infusion initiation to a bispectral index (BIS) < 60 (time to BIS60) and hemodynamic variables were measured and recorded.Results: The EC95 (95% CI) of Ce was 2.07 (1.94, 2.87) ng/ml. The overall time to BIS60 was 154.0 +/- 39.9 s. No patient experienced significant hypotension or bradycardia during remimazolam induction.Conclusions: The EC95 of remifentanil Ce was 2.07 (1.94, 2.87) ng/ml for successful i-gel insertion during remimazolam induction at 12 mg/kg/h without hemodynamic instability in adult patients. Future studies should measure remifentanil Ce in elderly patients or us-ing remimazolam at various infusion doses.
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