기관내삽관에 의한 혈역학적 반응을 억제하는 Remifentanil의 효과처 농도와 연령과의 관계분석 (An analysis of correlation between remifentanil effect site concentration and age blunting hemodynamic response to endotracheal intubation)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 4권 / 2호 / 113 ~ 117페이지
· 저자명 : 정영호, 이윤석, 임윤희, 권영석, 이우용, 연준흠, 이상석

초록

Background: There are many studies using propofol-remifentanil
target controlled infusion (TCI) for the prevention of adverse
hemodynamic changes during tracheal intubation. Most of these
studies suggested optimal remifentanil target concentration without
considering age. The purpose of this study is to analyze the
correlation between concentration of remifentanil and age to blunting
adverse hemodynamic responses during tracheal intubation.
Methods: We enrolled ASA physical state I or II 55 patients, aged
12−75 years undergoing elective surgery. Anesthesia was
induced using a propofol TCI (Marsh model). A 4μg/ml effect-site
concentration of propofol was chosen. Rocuronium 0.6 mg/kg was
administered after the patients lost consciousness. Remifentanil
TCI (Minto model) was started 1 minute after the propofol injection.
Initially, a 3 ng/ml effect-site concentration was chosen. The next
concentration was chosen using Dixon’s up-and-down method. The
non-invasive blood pressure and heart rate were recorded before
induction (baseline), after the remifentanil infusion, immediately after
intubation as well as 1 and 3 minutes after intubation.
Results: Probit analysis revealed a remifentanil effect site EC50
and EC95 in all patients to be 1.768 ng/ml (S.E. ± 0.136) and 2.912
ng/ml (S.E. ± 0.307). Final probit equation was as following consisted with age and remifentanil effect site concentration. Probit
= −2.588 ＋ 1.886 remifentanil effect site concentration −0.022
× Age.
Conclusions: The probability of success rate of blunting adverse
hemodynamic response is related to the concentration of
remifentanil directly and age inversely.

영어초록

Background: There are many studies using propofol-remifentanil
target controlled infusion (TCI) for the prevention of adverse
hemodynamic changes during tracheal intubation. Most of these
studies suggested optimal remifentanil target concentration without
considering age. The purpose of this study is to analyze the
correlation between concentration of remifentanil and age to blunting
adverse hemodynamic responses during tracheal intubation.
Methods: We enrolled ASA physical state I or II 55 patients, aged
12−75 years undergoing elective surgery. Anesthesia was
induced using a propofol TCI (Marsh model). A 4μg/ml effect-site
concentration of propofol was chosen. Rocuronium 0.6 mg/kg was
administered after the patients lost consciousness. Remifentanil
TCI (Minto model) was started 1 minute after the propofol injection.
Initially, a 3 ng/ml effect-site concentration was chosen. The next
concentration was chosen using Dixon’s up-and-down method. The
non-invasive blood pressure and heart rate were recorded before
induction (baseline), after the remifentanil infusion, immediately after
intubation as well as 1 and 3 minutes after intubation.
Results: Probit analysis revealed a remifentanil effect site EC50
and EC95 in all patients to be 1.768 ng/ml (S.E. ± 0.136) and 2.912
ng/ml (S.E. ± 0.307). Final probit equation was as following consisted with age and remifentanil effect site concentration. Probit
= −2.588 ＋ 1.886 remifentanil effect site concentration −0.022
× Age.
Conclusions: The probability of success rate of blunting adverse
hemodynamic response is related to the concentration of
remifentanil directly and age inversely.

참고자료

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