Remifentanil dose for laryngeal mask airway insertion with a single standard dose of propofol during emergency airway management in elderly patients.
BACKGROUND
This study determined the dose of remifentanil to use during insertion of a Classic™ laryngeal mask airway (LMA, The Laryngeal Mask Co., Nicosia, Cyprus) in elderly patients during emergency airway management when combined with a single dose of propofol.


METHODS
Patients aged 65-80 years were enrolled. Anesthesia was induced with propofol 1 mg/kg, and then a blinded dose of remifentanil was infused over 30 s after confirming the patient's loss of consciousness. The dose of remifentanil was determined using Dixon's up-and-down method, starting at 0.5 µg/kg (a step size of 0.1 µg/kg). Insertion of the LMA was attempted 60 s after loss of consciousness.


RESULTS
In total, 23 patients were recruited and the mean age ± standard deviation was 72 ± 3 years. The effective dose for successful LMA insertion in 50% of the patients (ED50) was 0.20 ± 0.05 µg/kg. No patient needed more than 0.3 µg/kg.


CONCLUSIONS
Remifentanil 0.20 ± 0.05 µg/kg with propofol 1 mg/kg resulted in excellent LMA insertion in 50% of elderly patients without significant hemodynamic changes during emergency airway management.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea.
Junghee
J
Ryu
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea.
Ah Young
AY
Oh
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea.
Ji-Seok
JS
Baek
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea.
Jin-Hee
JH
Kim
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hosptial, Seongnam, Korea.
Sang-Heon
SH
Park
Department of Anesthesiology and Pain Medicine, Seoul National University Hosptial, Seoul, Korea.
Jae-Mun
JM
Noh
Aged; Laryngeal mask airway; Remifentanil