The optimal concentration of remifentanil required for i-gel insertion in patients with simulated difficult airways
- Authors
- 전우재; 조상윤; 김경헌; 권용덕
- Issue Date
- Oct-2014
- Publisher
- 대한마취통증의학회
- Keywords
- Airway; Equipment; Remifentanil
- Citation
- Anesthesia and Pain Medicine, v.9, no.4, pp.258 - 262
- Indexed
- KCI
OTHER
- Journal Title
- Anesthesia and Pain Medicine
- Volume
- 9
- Number
- 4
- Start Page
- 258
- End Page
- 262
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/158927
- ISSN
- 1975-5171
- Abstract
- Background: Because difficult airways are not commonlyencountered, simulation of a difficult airway using a cervical collarhas become a well-established technique of for modeling difficultlaryngoscopic views and evaluating interventions for use in difficultairway scenarios. In this study, we have determined the optimalremifentanil concentrations (EC50 and EC95) required for i-gelinsertion in anesthetized patients fitted with cervical collars atpropofol effect-site concentrations of 4.0 and 6.0 μg/ml (group 4.0and group 6.0).
Methods: The remifentanil dosage for each propofol effect-siteconcentration group was determined by the modified Dixon’sup-and-down method using previous results. The experiment wasstarted using a 4.0 ng/ml effect-site remifentanil concentration, andthe dose was reduced by 0.5 ng/ml for the next attempt when tubeinsertion was successful; if tube insertion failed, the dose for thenext attempt was increased by 0.5 ng/ml.
Results: EC50 and EC95 were respectively 2.11 ng/ml (95% CI,1.78–2.26 ng/ml) and 2.44 ng/ml (95% CI, 2.28–3.67 ng/ml) for the4.0 group, and 0.42 ng/ml (95% CI, −1.30 to 0.77 ng/ml) and 0.75ng/ml (0.56–14.3 ng/ml) for the 6.0 group.
Conclusions: In this study, a cervical collar was attached andhead fixation was performed to induce a difficult airway. The optimalconcentration of remifentanil at a propofol effect-site concentrationof 4.0 μg/ml was greater than 2.44 ng/ml (95% CI, 2.28–3.67 ng/ml),and that at the propofol effect-site concentration of 6.0 μg/ml wasgreater than 0.75 ng/ml (0.56–14.3 ng/ml).
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