Optimal remifentanil dosage for providing excellent intubating conditions when co-administered with a single standard dose of propofol

Anaesthesia. 2009 Jul;64(7):719-26. doi: 10.1111/j.1365-2044.2009.05916.x.

Abstract

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Combined / administration & dosage*
  • Anesthetics, Intravenous / administration & dosage*
  • Anesthetics, Intravenous / pharmacology
  • Blood Pressure / drug effects
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Gynecologic Surgical Procedures
  • Heart Rate / drug effects
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / pharmacology
  • Intubation, Intratracheal / methods*
  • Middle Aged
  • Piperidines / administration & dosage*
  • Piperidines / pharmacology
  • Propofol / administration & dosage*
  • Remifentanil

Substances

  • Anesthetics, Combined
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Piperidines
  • Remifentanil
  • Propofol