title: Effect-site concentration of remifentanil for smooth inhalational induction with desflurane.
abstract: Objective To determine the effect-site concentration (Ce) of remifentanil target-controlled infusion required for a smooth inhalational induction without airway irritation using desflurane in a stepwise incremental manner for 50% of patients (EC50) and 95% of patients (EC95). Methods Patients with an American Society of Anesthesiologists physical status I and II, aged 19-60 years undergoing elective surgery were enrolled in this study. When target Ce of remifentanil was reached, desflurane was inhaled at 4 vol% initially and then it was increased to 8 and 12 vol% at intervals of 30 s. Smooth induction was regarded as an absence of airway irritation signs and excitatory movements. The EC50and EC95values for remifentanil were determined using a modified Dixon's up-and-down method as well as an isotonic regression method with a bootstrapping approach. Results The EC50and EC95of remifentanil for smooth induction during inhalation of desflurane were 3.40 ng/ml (95% confidence interval [CI] 2.42, 4.38 ng/ml) and 4.31 ng/ml (95% CI 2.15, 5.98 ng/ml), respectively. Conclusion Prior administration of remifentanil could provide smooth inhalational induction with desflurane in a stepwise increment.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Yoo
authors.affiliation: Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Jeong
authors.affiliation: Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Hyung Bae
authors.initials: HB
authors.lastname: Park
authors.affiliation: Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Yun Jeong
authors.initials: YJ
authors.lastname: Chae
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077335:Desflurane; D007530:Isoflurane; D000077208:Remifentanil
keywords: Anaesthetic techniques; desflurane; induction; remifentanil; target-controlled infusion