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Effect-site concentration of remifentanil for minimizing cardiovascular changes by inhalation of desflurane

Title
Effect-site concentration of remifentanil for minimizing cardiovascular changes by inhalation of desflurane
Authors
Jeong H.J.Baik H.J.Kim J.H.Kim Y.J.Bahk J.H.
Ewha Authors
김종학백희정김윤진
SCOPUS Author ID
김종학scopus; 백희정scopus; 김윤진scopus
Issue Date
2013
Journal Title
Yonsei Medical Journal
ISSN
0513-5796JCR Link
Citation
vol. 54, no. 3, pp. 739 - 746
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: This study aims to investigate the most appropriate effect-site concentration of remifentanil to minimize cardiovascular changes during inhalation of high concentration desfurane. Materials and Methods: Sixty-nine American Society of Anesthesiologists physical status class I patients aged 20-65 years were randomly allocated into one of three groups. Anesthesia was induced with etomidate and ro-curonium. Remifentanil was infused at effect-site concentrations of 2, 4 and 6 ng/ mL in groups R2, R4 and R6, respectively. After target concentrations of remifentanil were reached, desfurane was inhaled to maintain the end-tidal concentration of 1.7 minimum alveolar concentrations for 5 minutes (over-pressure paradigm). The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and end-tidal concentration of desfurane were measured for 5 minutes. Results: The end-tidal concentration of desfurane increased similarly in all groups. The SBP, DBP, MAP and HR within group R4 were not significantly different as compared with baseline values. However, measured parameters within group R2 increased significantly 1-3 minutes after desfurane inhalation. The MAP within group R6 decreased significantly at 1, 2, 4, and 5 minutes (p<0.05). There were significant differences in SBP, DBP, MAP and HR among the three groups 1-3 minutes after inhalation (p<0.05). The incidence of side effects such as hyper- or hypo-tension, and tachyor brady-cardia in group R4 was 4.8% compared with 21.8% in group R2 and 15.0% in group R6. Conclusion: The most appropriate effect-site concentration of remifentanil for blunting hemodynamic responses by inhalation of high concentration desfurane is 4 ng/mL. © Yonsei University College of Medicine 2013.
DOI
10.3349/ymj.2013.54.3.739
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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