Remifentanil dose for laryngeal mask airway insertion with a single standard dose of propofol during emergency airway management in elderly patients
Korean Journal of Anesthesiology 2014³â 66±Ç 4È£ p.278 ~ p.282
À¯Á¤Èñ(Ryu Jung-Hee) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
¿À¾Æ¿µ(Oh Ah-Young) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
(Baek Ji-Seok) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
±èÁøÈñ(Kim Jin-Hee) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
¹Ú»óÇå(Park Sang-Heon) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
(Noh Jae-Mun) - Seoul National University Bundang Hospital Department of Anesthesiology and Pain Medicine
Abstract
Background: This study determined the dose of remifentanil to use during insertion of a Classic¢â laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol.
Methods: Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient¡¯s loss of consciousness. The dose of remifentanil was determined using Dixon¡¯s up-and-down method, starting at 0.5 ¥ìg/kg (a step size of 0.1 ¥ìg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness.
Results: In total, 23 patients were recruited and the mean age ¡¾ standard deviation was 72 ¡¾ 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 ¡¾ 0.05 ¥ìg/kg. No patient needed more than 0.3 ¥ìg/kg.
Conclusions: Remifentanil 0.20 ¡¾ 0.05 ¥ìg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.
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Aged, Laryngeal mask airway, Remifentanil
KMID :
0356920140660040278
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