Remifentanil과 Propofol을 이용한 전정맥 마취 시 두 약제의 상호작용 및 적정 투여량 (The Interaction between Remifentanil and Propofol during Total Intravenous Anesthesia and the Adequate Effect Site Concentration)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Korean Journal of Anesthesiology / 54권 / 2호 / 139 ~ 145페이지
· 저자명 : 김원호, 안현주

초록

This study was performed to evaluate the interaction between remifentanil and propofol by comparing median-effect concentration (EC50) of single and co-administration, and to find adequate combination doses for general anesthesia for gastrectomy.
Methods:Thirty-six ASA physical status 1 or 2 patients scheduled for gastrectomy were randomly assigned to the remifentanil, propofol, or combination group.To obtain the dose-effect curve of remifentanil or propofol only, the effect site concentration of each drug was escalated until bispectral index (BIS) was reached 40 by a target-controlled infusion (TCI) during the steady operational period.For the combination group, 0.25, 0.5, 1, 2, and 2.5 timed EC50 of each drug were co-administered.The heart rate, mean arterial pressure and BIS were measured during the study period.The interaction between remifentanil and propofol was analyzed with using isobologram.
Results:The EC50 of remifentanil for hypnosis (BIS 40) was 1.96 ng/ml, and that of propofol was 1.35μg/ml.In the combination group, the EC50 of remifentanil was 0.81 ng/ml and that of propofol was 0.56μg/ml.EC90 of remifentanil and propofol alone were 13.43 ng/ml and 4.88μg/ml. For EC90 of the combination group, remifentanil 3.54 ng/ml and propofol 2.50 μg/ml were required.The distance from the theoretical additive line in the isobologram was larger in the higher doses (EC50 ＜ EC75 ＜ EC90).
Conclusions:This study shows that remifentanil and propofol reveal synergism by isobolographic analysis during intravenous anesthesia.

영어초록

This study was performed to evaluate the interaction between remifentanil and propofol by comparing median-effect concentration (EC50) of single and co-administration, and to find adequate combination doses for general anesthesia for gastrectomy.
Methods:Thirty-six ASA physical status 1 or 2 patients scheduled for gastrectomy were randomly assigned to the remifentanil, propofol, or combination group.To obtain the dose-effect curve of remifentanil or propofol only, the effect site concentration of each drug was escalated until bispectral index (BIS) was reached 40 by a target-controlled infusion (TCI) during the steady operational period.For the combination group, 0.25, 0.5, 1, 2, and 2.5 timed EC50 of each drug were co-administered.The heart rate, mean arterial pressure and BIS were measured during the study period.The interaction between remifentanil and propofol was analyzed with using isobologram.
Results:The EC50 of remifentanil for hypnosis (BIS 40) was 1.96 ng/ml, and that of propofol was 1.35μg/ml.In the combination group, the EC50 of remifentanil was 0.81 ng/ml and that of propofol was 0.56μg/ml.EC90 of remifentanil and propofol alone were 13.43 ng/ml and 4.88μg/ml. For EC90 of the combination group, remifentanil 3.54 ng/ml and propofol 2.50 μg/ml were required.The distance from the theoretical additive line in the isobologram was larger in the higher doses (EC50 ＜ EC75 ＜ EC90).
Conclusions:This study shows that remifentanil and propofol reveal synergism by isobolographic analysis during intravenous anesthesia.

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