The effect of remifentanil on the minimum alveolar concentration of isoflurane in children
| Autor: | Jing-rui Yu, Ben-zhen Chen, Qin-jun Chu, Ling Tan, Yu-sheng Yao |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Minimum alveolar concentration medicine.medical_specialty Remifentanil Endotracheal intubation Hernia Inguinal Double-Blind Method Piperidines medicine Humans Prospective Studies Child Herniorrhaphy Skin incision Isoflurane business.industry medicine.disease Surgery Pulmonary Alveoli Inguinal hernia Anesthesiology and Pain Medicine Anesthesia Child Preschool Anesthetics Inhalation Ceiling effect Female business Anesthesia Inhalation Surgical incision Anesthetics Intravenous medicine.drug |
| Zdroj: | Journal of clinical anesthesia. 27(6) |
| ISSN: | 1873-4529 |
| Popis: | Study objective To evaluate the effect of remifentanil on the isoflurane end-tidal concentration required to eliminate movement reaction upon surgical incision in children. Design Prospective, double blinded, serial study. Setting Operating room of a university-affiliated hospital. Patients Patients of ASA status 1 or 2, aged 4 to 7 years, scheduled for either inguinal hernia repair or orchidopexy surgery with general anesthesia. Interventions and measurements After endotracheal intubation, 108 children serially received 1 of 6 dose (nil, 0.05, 0.10, 0.15, 0.20, or 0.25 μg kg −1 min −1 ) of remifentanil. End-tidal isoflurane concentration was adjusted according to a Dixon's up-and-down approach. Twenty-five minutes after starting the remifentanil infusion, the surgical incision was performed. The response of patients was classified as either "response" or "no response." Response was defined as a purposeful response in response to skin incision. Main Results The MAC of isoflurane were 1.50 ± 0.16%, 1.33 ± 0.27%, 0.93 ± 0.13%, 0.73 ± 0.27%, 0.63 ± 0.19%, and 0.60 ± 0.15% for remifentanil infusion rates of nil, 0.05, 0.10, 0.15, 0.20, and 0.25 μg kg −1 min −1 , respectively. Conclusion The MAC of isoflurane decreased with increasing infusion rate of remifentanil, showing an initial step reduction followed by a ceiling effect. |
| Databáze: | OpenAIRE |
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