Propofol-remifentanil 목표농도조절주입 시 Rocuronium 용량에 따른 삽관 조건의 비교 (Comparison of intubating conditions according to different doses of rocuronium during propofol-remifentanil target controlled infusion)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Korean Journal of Anesthesiology / 55권 / 1호 / 26 ~ 30페이지
· 저자명 : 정유순, 윤희석

초록

Many studies have shown that tracheal intubation can be facilitated by propofol-remifentanil without muscle relaxant. But low dose of rocuronium can improve intubating condition and reduce the requirement of remifentanil. This study evaluated the optimal dose of rocuronium for tracheal intubation according to different doses of rocuronium during propofol-remifentanil target controlled infusion (TCI).
Methods: Sixty, ASA I-II patients were randomly divided into three groups (n = 20). Anesthesia was induced with remifentanil 3.0 ng/ml and propofol 3.5μg/ml target controlled infusion. After patients lost consciousness, rocuronium was administrated 0.6 mg/kg (R0.6), 0.45 mg/kg (R0.45), 0.3 mg/kg (R0.3) for each group. Three minutes later, a laryngoscope and tracheal intubation were tried, intubating condition were measured. Also blood pressure and heart rate were measured before induction, preintubation, postintubation.
Results: Clinically acceptable intubation condition (excellent or good) were observed 100%, 100%, 85% of patients in the R0.6, R0.45, and R0.3 groups. Eighty five percents of patients in groups R0.6, R0.45 had excellent intubation condition. But only 35% in group R0.3 showed excellent intubating condition (P ＜ 0.05) and 15% in group R0.3 showed poor intubating condition. There were no significant elevation mean blood pressure (MBP), heart rate (HR) after tracheal intubation in all groups. And there were no significant differences among groups.
Conclusions: The optimal dose of rocuronium for clinical acceptable intubating condition could be reduced to 1.5 × ED95 under total intravenous anesthesia with remifentanil 3.0 ng/ml and propofol 3.5μg/ml target controlled infusion.

영어초록

Many studies have shown that tracheal intubation can be facilitated by propofol-remifentanil without muscle relaxant. But low dose of rocuronium can improve intubating condition and reduce the requirement of remifentanil. This study evaluated the optimal dose of rocuronium for tracheal intubation according to different doses of rocuronium during propofol-remifentanil target controlled infusion (TCI).
Methods: Sixty, ASA I-II patients were randomly divided into three groups (n = 20). Anesthesia was induced with remifentanil 3.0 ng/ml and propofol 3.5μg/ml target controlled infusion. After patients lost consciousness, rocuronium was administrated 0.6 mg/kg (R0.6), 0.45 mg/kg (R0.45), 0.3 mg/kg (R0.3) for each group. Three minutes later, a laryngoscope and tracheal intubation were tried, intubating condition were measured. Also blood pressure and heart rate were measured before induction, preintubation, postintubation.
Results: Clinically acceptable intubation condition (excellent or good) were observed 100%, 100%, 85% of patients in the R0.6, R0.45, and R0.3 groups. Eighty five percents of patients in groups R0.6, R0.45 had excellent intubation condition. But only 35% in group R0.3 showed excellent intubating condition (P ＜ 0.05) and 15% in group R0.3 showed poor intubating condition. There were no significant elevation mean blood pressure (MBP), heart rate (HR) after tracheal intubation in all groups. And there were no significant differences among groups.
Conclusions: The optimal dose of rocuronium for clinical acceptable intubating condition could be reduced to 1.5 × ED95 under total intravenous anesthesia with remifentanil 3.0 ng/ml and propofol 3.5μg/ml target controlled infusion.

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