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Concentration of remifentanil needed for tracheal intubation with sevoflurane at 1 MAC in adult patients

Published online by Cambridge University Press:  25 November 2005

F. Sztark ,
F. Chopin ,
A. Bonnet  and
A. M. Cros
F. Sztark
Affiliation:
Centre Hospitalier Universitaire Pellegrin, Département d'Anesthésie-Réanimation I, Bordeaux, France
F. Chopin
Affiliation:
Centre Hospitalier Universitaire Pellegrin, Département d'Anesthésie-Réanimation IV, Bordeaux, France
A. Bonnet
Affiliation:
Centre Hospitalier Universitaire Pellegrin, Département d'Anesthésie-Réanimation IV, Bordeaux, France
A. M. Cros
Affiliation:
Centre Hospitalier Universitaire Pellegrin, Département d'Anesthésie-Réanimation IV, Bordeaux, France
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Extract

Summary

Background and objective: Inhalation induction with sevoflurane provides acceptable conditions for tracheal intubation. Opioids significantly decrease the alveolar concentration needed to achieve tracheal intubation. The purpose of this study was to determine the target concentration of remifentanil providing excellent conditions for tracheal intubation with sevoflurane at 1 minimum alveolar concentration without muscle relaxant. Methods: Twenty-four consecutive patients, aged 18–50 yr, ASA I or II, were studied. Induction of anaesthesia was performed with sevoflurane at age-adjusted minimum alveolar concentration. Remifentanil was simultaneously administered using target-controlled infusion with the Minto model. Target plasma concentration of remifentanil was selected for each patient according to an up-and-down method. Results: The mean target concentration of remifentanil for successful tracheal intubation was 3.3 ng mL−1 (95% confidence interval: 2.6–3.9 ng mL−1). Arterial pressure, heart rate and bispectral index did not increase after tracheal intubation in the group of patients with successful intubation. Conclusions: Remifentanil at 3.3 ng mL−1 together with sevoflurane at 1 minimum alveolar concentration provides excellent conditions for tracheal intubation in 50% of patients.

Keywords

ANAESTHETICS, INHALATION, sevofluraneOPIOIDS, remifentanilINTUBATION INTRATRACHEAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 12 , December 2005 , pp. 919 - 924
Copyright
© 2005 European Society of Anaesthesiology

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