Dose requirements of remifentanil for intubation in nonparalyzed Chinese children.
BACKGROUND
The objective of this study was to determine ED50 and ED95 of remifentanil for intubation combined with propofol in nonparalyzed Chinese children.


METHODS
Forty-seven American Society of Anesthesiologists Class I children aged 4-11 years weighing 14-33.5 kg underwent general anesthesia with 2.5 mg·kg(-1) of intravenous propofol followed by remifentanil in Wenzhou, China. The initial dose of remifentanil was 2.5 μg·kg(-1) injected over 60 s. Intubation was attempted 30 s after the completion of remifentanil injection. Level of difficulty to intubate was graded on a scoring system. If the initial intubation condition was deemed satisfactory, subsequent remifentanil doses were decreased by 0.25 μg·kg(-1). If the intubating condition was deemed unsatisfactory, subsequent remifentanil doses were increased by 0.25 μg·kg(-1). Mean arterial pressure, heart rate, and pulse oximetry were documented before and after induction, immediately after intubation, and 1 min after intubation.


RESULTS
The ED50 of remifentanil used to render a satisfactory intubating condition used in combination with 2.5 mg·kg(-1) of propofol in nonparalyzed Chinese children was 2.30 μg·kg(-1) (95% confidence interval: 2.28-2.31 μg·kg(-1)), and the ED95 is 2.75 μg·kg(-1) (95% confidence interval: 2.59-3.35 μg·kg(-1)). These doses were lower than previously reported.


CONCLUSIONS
When used in combination with 2.5 mg·kg(-1) of intravenous propofol, ED50 and ED95 of remifentanil for adequate intubation in nonparalyzed children were lower than previously reported, at 2.30 and 2.75 μg·kg(-1), respectively.
Department of Anesthesiology, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Hua-Cheng
HC
Liu
Wei-Ke
WK
Tao
Rui-Feng
RF
Zeng
Wang-Ning
WN
ShangGuang
Jun
J
Li
Wen-Guang
WG
Huang
Zhang-Lei
ZL
Dong
Xin
X
Wang
Qing-Quan
QQ
Lian
D000704:Analysis of Variance; D019162:Anesthetics, Combined / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002681:China; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol
ED50; ED95; children; endotracheal intubation; propofol; remifentanil