title: Target-controlled remifentanil in combination with propofol for spontaneously breathing day-case patients.
abstract: Remifentanil is a new potent opioid with a very short duration of action irrespective of duration of infusion. It may have a role in day-case anaesthesia as part of a balanced total intravenous anaesthetic technique with propofol. We examined the respiratory depressant effects of remifentanil in 20 patients undergoing day-case anaesthesia. The target plasma concentration of remifentanil was varied while maintaining a constant target-controlled infusion of 4.5 microg x ml-1 propofol. In only 12 patients was satisfactory spontaneous respiration maintained. In these patients the median remifentanil target concentration was 1.6 ng x ml-1 and was achieved with a median infusion rate of 0.05 microg x kg-1 x min-1. The range of target concentrations associated with satisfactory spontaneous respiration was wide and varied over a 4.7-fold range from 0.6 to 2.8 ng x ml-1.
authors.affiliation: University Department of Anaesthesia, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Murdoch
authors.forename: R A
authors.initials: RA
authors.lastname: Hyde
authors.forename: G N
authors.initials: GN
authors.lastname: Kenny
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000494:pharmacology*; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D010880:Piperidines / Q000008:administration & dosage / Q000494:pharmacology*; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D000077208:Remifentanil; D012119:Respiration / Q000187:drug effects*
chemical_list: D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol