한국인에서 Propofol-Remifentanil 전정맥 마취시 기관내 삽관에 따르는 혈압과 맥박수의 증가를 예방하기 위한 Remifentanil의 효과처 농도

• Published in: Korean journal of anesthesiology Vol. 51; no. 3; pp. 312 - 317
• Main Authors: 신혜란, Helen Ki Shinn, 이홍식, Hong Sik Lee, 이춘수, Choon Soo Lee, 정종권, Chong Kweon Chung, 차두천, Doo Cheon Cha, 김혜하, Hye Ha Kim, 송장호, Jang Ho Song
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회 30.09.2006
• Subjects: propofol; remifentanil; sex differences; target-controlled infusion; TCI; tracheal intubation; 마취과학
• ISSN: 2005-6419; 2005-7563

Background: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4μg/ml) and to find any sexual differences. Methods: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4μg/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. Results: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 ng/ml) in male group and 1.05 ng/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. Conclusions: Relatively small dosages of remifentanil (0.68-1.81 ng/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences. (Korean J Anesthesiol 2006; 51: 312~7)