当前位置： SCI文献检索 > Minerva Anestesiologica期刊下所有文献 > The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery.

The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery.

Abstract：

BACKGROUND:Remifentanil has been suggested as a suitable agent for conscious sedation during fibreoptic intubation. We evaluated the optimal effect site concentration (Ce) of remifentanil target-controlled infusion (TCI) for awake nasotracheal fibreoptic intubation in patients undergoing elective cervical spine surgery. METHODS:Nineteen ASA I-II patients were enrolled. Patients were premedicated with midazolam (<70 kg 1.5 mg; >70 kg 2.0 mg) intravenously. The EC(50) and EC(95) of remifentanil Ce for smooth intubation were determined using Dixon's up-and-down method and isotonic regression. Smooth intubation was considered to have failed when patients exhibited sustained and repetitive coughing with head lift during the procedure. Intubation time, number of attempts, adverse events, and hemodynamic variables were also recorded. Patients were asked to recall the procedure and grade satisfaction at postoperative 24 h. RESULTS:The EC(50) of remifentanil Ce for smooth intubation was 2.33±0.38 ng·mL-1 as calculated by Dixon's method. The estimated EC(95) of remifentanil Ce was 3.38 (95% confidence interval 2.90-3.46) ng·mL-1. Median intubation time (min) was longer in failed smooth intubation than in smooth intubation (8.0 vs. 6.1, P=0.048). Eleven patients (58%) recalled the procedure and 16 patients (84%) rated their satisfaction score as good or excellent. CONCLUSION:The estimated EC(95) of remifentanil Ce for smooth nasotracheal fibreoptic intubation with conscious sedation was 3.38 (95% CI 2.90-3.46) ng·mL-1 when used in combination with midazolam and topical lidocaine. Remifentanil TCI may provide a tolerable experience of awake fibreoptic intubation despite the high incidence of recall.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Song JW,Kwak YL,Lee JW,Chang CH,Kim HS,Shim YH

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

521-6

issue

eissn

0375-9393

issn

1827-1596

pii

R02127268

journal_volume

pub_type

杂志文章

在线工具

The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery.