Effect-site concentration of remifentanil for nasotracheal versus orotracheal intubation during target-controlled infusion of propofol

J Int Med Res. 2011;39(5):1816-23. doi: 10.1177/147323001103900524.

Abstract

The concentration of remifentanil required for acceptable nasotracheal intubation in adults after target-controlled infusion (TCI) of propofol without neuromuscular blockade was compared with that required for orotracheal intubation. Twenty-five patients undergoing oral and maxillofacial surgery received nasotracheal intubation and 25 undergoing ear, nose and throat surgery received orotracheal intubation. Anaesthesia was induced with propofol TCI at a target effect-site concentration of 5.0 μg/ml. The 50% and 95% effective concentrations (EC(50) and EC(95), respectively) for remifentanil, calculated using isotonic regression, were 5.40 and 6.85 ng/ml, respectively, in the orotracheal group and 5.75 and 7.43 ng/ml in the nasotracheal group. The EC(50) (± SD) values for remifentanil, calculated using a modified Dixon's up-and-down method, were 6.08 ± 0.75 and 5.58 ± 0.75 ng/ml for nasotracheal and orotracheal intubation, respectively. Effect-site remifentanil concentrations did not differ significantly between the two groups of patients. Coadministration of propofol and remifentanil can provide acceptable conditions for nasotracheal intubation without neuromuscular blockade.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Anesthetics, Combined*
  • Anesthetics, Intravenous*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Intubation, Intratracheal*
  • Male
  • Middle Aged
  • Mouth
  • Nose
  • Oral Surgical Procedures
  • Piperidines / therapeutic use*
  • Propofol / therapeutic use*
  • Remifentanil
  • Young Adult

Substances

  • Anesthetics, Combined
  • Anesthetics, Intravenous
  • Piperidines
  • Remifentanil
  • Propofol