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Determination of sevoflurane alveolar concentration for tracheal intubation with remifentanil, and no muscle relaxant
Author(s) -
Cros A. M.,
Lopez C.,
Kandel T.,
Sztark F.
Publication year - 2000
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2000.01538.x
Subject(s) - remifentanil , medicine , sevoflurane , anesthesia , tracheal intubation , intubation , heart rate , mean arterial pressure , muscle relaxant , ventilation (architecture) , blood pressure , propofol , mechanical engineering , engineering
The sevoflurane alveolar concentration needed for tracheal intubation with remifentanil was studied in 26 adult patients premedicated with 100 mg hydroxyzine. Anaesthesia was induced with sevoflurane in oxygen. The concentration was determined by Dixon's up‐and‐down method. The first patient was tested at 4.5%. One minute after obtaining the preselected value, remifentanil 1 µg.kg −1 was injected for 60 s followed by an infusion of 0.25 µg.kg −1 .min −1 . Ventilation was then manually assisted for 2 min and tracheal intubation was attempted. Tracheal intubation conditions and responses to intubation were noted. Heart rate and mean arterial pressure were recorded before induction, before remifentanil injection, and before and 3 min after tracheal intubation. The concentration for acceptable intubating conditions was 2.5 ± 0.7%. From logistic regression, ED 50 and ED 95 were 2.0% (95% CI 1.3–2.5) and 3.2% (95% CI 2.6–5.6), respectively. With sevoflurane 2.5%, heart rate and mean arterial pressure decreased by 18% and 15%, respectively, after remifentanil administration and increased slightly after tracheal intubation.