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Effect‐site concentration of remifentanil attenuating surgical stress index responses to intubation of the trachea
Author(s) -
Mustola S.,
Toivonen J.
Publication year - 2010
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.1365-2044.2010.06329.x
Subject(s) - medicine , remifentanil , intubation , anesthesia , fight or flight response , propofol , biochemistry , chemistry , gene
Summary Surgical Stress Index has been proposed for assessment of surgical stress and analgesia. It is a numeric index based on the normalised pulse beat interval and photoplethysmographic pulse wave amplitude. We determined the effect‐site concentration of remifentanil for attenuation of Surgical Stress Index responses to intubation of the trachea. Thirty ASA 1–2 patients received either deep or normal anaesthesia and then target‐controlled remifentanil. Burst suppression was maintained in the deep group and state entropy at 40–60 (scale 0–91) in the normal group. Mean (SD) effect‐site concentrations of remifentanil attenuating responses in 50% of patients were 2.13 (0.25) ng.ml −1 and 3.05 (0.27) ng.ml −1 in deep and normal groups, respectively (p = 0.034). From probit analysis, EC 50 and EC 95 of remifentanil (95% CI) were 2.34 (1.97–2.71) ng.ml −1 and 3.19 (2.69–3.69) ng.ml −1 in deep group and 3.17 (2.67–3.67) ng.ml −1 and 3.79 (3.21–4.37) ng.ml −1 in the normal group, respectively. The values from probit analysis and up‐and‐down method did not differ significantly.