title: The optimal dose of remifentanil for intubation during sevoflurane induction without neuromuscular blockade in children.
abstract: 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 microg x kg(-1) as a step size). The first patient was tested at 1.0 microg x 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) microg x 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 microg x kg(-1) (95% confidence limits 0.63-1.38 microg x kg(-1)).
authors: Department of Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: S K
authors: SK
authors: Min
authors: Y L
authors: YL
authors: Kwak
authors: S Y
authors: SY
authors: Park
authors: J S
authors: JS
authors: Kim
authors: J Y
authors: JY
authors: Kim
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008738:Methyl Ethers; D019148:Neuromuscular Blockade; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil