실제 체중과 이상적 체중에 근거한 Remifentanil 투여 용량이 기관 내 삽관 상태와 혈역학적 부작용에 미치는 영향 (Effects of Dosages of Remifentanil Calculated by Total Body Weight and Ideal Body Weight to Intubation Circumstances and Adverse Hemodynamic Responses)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 2권 / 1호 / 14 ~ 21페이지
· 저자명 : 김신성

초록

Background: Remifentanil presents good intubation conditions and
blunting adverse hemodynamic responses following intubation. So,
we evaluated to determine optimal dosage of remifentanil for intubation
which consider ideal body weight.
Methods: 160 ASA class 1-2 patients were selected and divided
4 groups, which were composed of 40 patients. Group 1 and 2 were
administrated dosage calculated by TBW (total body weight). Each
group was administrated intravenous continuous infusion dose of 1.0
ug/kg/min of remifentanil during 2 minutes followed by intravenous
bolus dose of 2 mg/kg of propofol (Group 1) and 2.0 ug/kg/min of
remifentanil followed by same dose of propofol (Group 2). Group
3 and 4 were administerated same dosage of Group 1 and 2 but
administrated dosage calculated by IBW (ideal body weight). We
didn’t use any muscle relaxant. Intubation conditions and postintubation
hemodynamic responses were assessed by 5 items based
on GCRP (good clinical research practice), MAP (mean arterial
pressure) and HR (heart rate).
Results: We have done intubation safely 60, 75, 55 and 98% of
Group 1, 2, 3 and 4 respectively. Group 1, 3 have ‘technically unacceptable’
cases, but group 2, 4 have ‘clinically unacceptable’ cases.
Hemodynamic responses of Group 4 were more stable than Group
2, especially obese patients. Obese patients present a problem for
the appropriate dosing of remifentanil and profound hypotension
and/or bradycardia developed more frequently when administerated
agent calculated by total body weight.
Conclusions: The optimal dosage which produce best intubation
conditions and least side effects has to be determined according to
IBW.

영어초록

Background: Remifentanil presents good intubation conditions and
blunting adverse hemodynamic responses following intubation. So,
we evaluated to determine optimal dosage of remifentanil for intubation
which consider ideal body weight.
Methods: 160 ASA class 1-2 patients were selected and divided
4 groups, which were composed of 40 patients. Group 1 and 2 were
administrated dosage calculated by TBW (total body weight). Each
group was administrated intravenous continuous infusion dose of 1.0
ug/kg/min of remifentanil during 2 minutes followed by intravenous
bolus dose of 2 mg/kg of propofol (Group 1) and 2.0 ug/kg/min of
remifentanil followed by same dose of propofol (Group 2). Group
3 and 4 were administerated same dosage of Group 1 and 2 but
administrated dosage calculated by IBW (ideal body weight). We
didn’t use any muscle relaxant. Intubation conditions and postintubation
hemodynamic responses were assessed by 5 items based
on GCRP (good clinical research practice), MAP (mean arterial
pressure) and HR (heart rate).
Results: We have done intubation safely 60, 75, 55 and 98% of
Group 1, 2, 3 and 4 respectively. Group 1, 3 have ‘technically unacceptable’
cases, but group 2, 4 have ‘clinically unacceptable’ cases.
Hemodynamic responses of Group 4 were more stable than Group
2, especially obese patients. Obese patients present a problem for
the appropriate dosing of remifentanil and profound hypotension
and/or bradycardia developed more frequently when administerated
agent calculated by total body weight.
Conclusions: The optimal dosage which produce best intubation
conditions and least side effects has to be determined according to
IBW.

참고자료

· 없음