Effect-site concentration of remifentanil for minimizing cardiovascular changes by inhalation of desflurane

This study aims to investigate the most appropriate effect-site concentration of remifentanil to minimize cardiovascular changes during inhalation of high concentration desflurane. Sixty-nine American Society of Anesthesiologists physical status class I patients aged 20-65 years were randomly alloca...

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Bibliographic Details
Published in:Yonsei medical journal 2013, 54(3), , pp.739-746
Main Authors: Jeong, Hee Jin, Baik, Hee Jung, Kim, Jong Hak, Kim, Youn Jin, Bahk, Jae Hyon
Format: Article
Language:English
Subjects:
Adult
Aged
Androstanols - adverse effects
Androstanols - pharmacology
Anesthetics - adverse effects
Anesthetics - pharmacology
Anesthetics, Inhalation - adverse effects
Anesthetics, Inhalation - pharmacology
Blood Pressure - drug effects
Etomidate - adverse effects
Etomidate - pharmacology
Female
Heart - drug effects
Heart Rate - drug effects
Humans
Isoflurane - adverse effects
Isoflurane - analogs & derivatives
Isoflurane - pharmacology
Male
Middle Aged
Original
Piperidines - adverse effects
Piperidines - therapeutic use
Protective Agents - adverse effects
Protective Agents - therapeutic use
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Summary:This study aims to investigate the most appropriate effect-site concentration of remifentanil to minimize cardiovascular changes during inhalation of high concentration desflurane. Sixty-nine American Society of Anesthesiologists physical status class I patients aged 20-65 years were randomly allocated into one of three groups. Anesthesia was induced with etomidate and rocuronium. Remifentanil was infused at effect-site concentrations of 2, 4 and 6 ng/mL in groups R2, R4 and R6, respectively. After target concentrations of remifentanil were reached, desflurane was inhaled to maintain the end-tidal concentration of 1.7 minimum alveolar concentrations for 5 minutes (over-pressure paradigm). The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and end-tidal concentration of desflurane were measured for 5 minutes. The end-tidal concentration of desflurane increased similarly in all groups. The SBP, DBP, MAP and HR within group R4 were not significantly different as compared with baseline values. However, measured parameters within group R2 increased significantly 1-3 minutes after desflurane inhalation. The MAP within group R6 decreased significantly at 1, 2, 4, and 5 minutes (p
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2013.54.3.739