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The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children
Author(s) -
Min S. K.,
Kwak Y. L.,
Park S. Y.,
Kim J. S.,
Kim J. Y.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05037.x
Subject(s) - remifentanil , medicine , sevoflurane , anesthesia , tracheal intubation , inhalation , neuromuscular blockade , intubation , bolus (digestion) , effective dose (radiation) , surgery , propofol , radiology
Summary The optimal dose of remifentanil needed to produce successful intubating conditions following inhalation induction of anaesthesia using 5% sevoflurane without the use of neuromuscular blocking drugs, was investigated in 25 children aged 3–10 years. Sixty seconds after inhalation induction of anaesthesia using sevoflurane 5% in 100% oxygen, a predetermined dose of remifentanil was injected over 30 s. The dose of remifentanil was determined using the modified Dixon's up‐and‐down method (0.2 μg.kg −1 as a step size). The first patient was tested at 1.0 μg.kg −1 remifentanil. Ninety seconds following the bolus administration of remifentanil, the child's trachea was intubated. The optimal bolus dose of remifentanil required for successful tracheal intubation was 0.56 (0.15) μg.kg −1 in 50% of children during inhalation induction using 5% sevoflurane in the absence of neuromuscular blocking drugs. Using probit analysis, the 95% effective dose (ED 95 ) of remifentanil was 0.75 μg.kg −1 (95% confidence limits 0.63–1.38 μg.kg −1 ).