Premium
Tracheal intubating conditions using propofol and remifentanil target‐controlled infusions
Author(s) -
Troy A. M.,
Hutchinson R. C.,
Easy W. R.,
Kenny G. N.
Publication year - 2002
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.1365-2044.2002.02624_3.x
Subject(s) - medicine , remifentanil , laryngoscopy , anesthesia , intubation , propofol , heart rate , tracheal intubation , mean arterial pressure , elective surgery , blood pressure , pulse oximetry
Summary Using target‐controlled infusions (TCI) we aimed to determine the most appropriate dose of remifentanil required for intubation, using a steady effect‐site concentration of propofol and without the use of neuromuscular blocking drugs. Sixty ASA I−II patients presenting for elective surgery were randomly allocated to one of three groups. Anaesthesia was induced in all patients using a target‐controlled infusion of propofol 6.5 µ g.ml −1 . This was reduced to 3 µ g.ml −1 after 1 min. Each group received a different TCI of remifentanil, 19, 15 or 11 ng.ml −1 , which was reduced to 10, 8 or 6 ng.ml −1 , respectively, after 1 min. Laryngoscopy and intubation were attempted at 4 min. Laryngoscopy and ease of intubation were assessed using a standard scoring system. Intubation was considered satisfactory in 75% of patients in groups 1 and 2 and 35% of patients in group 3. Intubation was successful in 20/20, 19/20 and 15/20 patients in groups 1, 2 and 3, respectively. Pulse oximetry, heart rate and noninvasive arterial pressure were measured pre‐induction, and at intervals until after laryngoscopy and intubation. Mean arterial pressure (MAP) and heart rate decreased following induction of anaesthesia in all groups, which was statistically significant. Following laryngoscopy, MAP and heart rate increased, but were significantly less than the corresponding baseline values.