Optimal remifentanil dosage for providing excellent intubating conditions when co-administered with a single standard dose of propofol.
This dose-response study aimed to determine the dose of remifentanil combined with propofol 2.5 mg.kg(-1) which provided excellent intubation conditions in 95% of patients. Ninety premedicated female ASA 1 and 2 patients were randomly allocated to five remifentanil dose groups (1, 2, 3, 4 or 5 microg.kg(-1)). Induction of anaesthesia was performed with a blinded dose of remifentanil infused over 60 s simultaneously co-administered with propofol 2.5 mg.kg(-1) infused over 45 s. Tracheal intubation was attempted 150 s after the beginning of induction. Intubating conditions were assessed with the Copenhagen score. A probit analysis was performed to calculate the intubating efficient doses (IED) of remifentanil in 95% of patients (IED(95)). Our data revealed that the IED(95) of remifentanil was 4.0 (95% CI: 3.4-5.6) microg.kg(-1), which was associated with a maximum decrease in heart rate and mean arterial pressure of < 30%, a finding which also applied to the other groups.
Bouvet
L
L
Claude Bernard University, University of Lyon, Lyon, France. lionel.bouvet@chu-lyon.fr
Stoian
A
A
Rimmelé
T
T
Allaouchiche
B
B
Chassard
D
D
Boselli
E
E
D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology; D007442:Intubation, Intratracheal / Q000379:methods*; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage* / Q000494:pharmacology; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol