EC(50) of remifentanil to prevent withdrawal movement associated with injection of rocuronium.

Journal of Anesthesia
Ji Young YoonTae Kyun Kim

Abstract

Various strategies have been studied to reduce the discomfort of rocuronium injection. This study was designed to determine the effect-site target concentration (Ce) of remifentanil at which there was a 50% probability of preventing movement from pain in response to the injection of rocuronium (EC(50)). Anesthesia was induced with a propofol target-controlled infusion (TCI, Marsh model) and remifentanil TCI (Minto model). Effect-site target concentration of propofol was 3 microg/ml. Ce of remifentanil for the first patient started at 2.0 ng/ml. Ce of remifentanil for each subsequent patient was determined by the response of the previous patient by the Dixon up-and-down method with an interval of 0.5 ng/ml. After both drugs reached target concentration, rocuronium 0.8 mg/kg was administered, and the pain response was observed. The EC(50) of remifentanil was 1.5 +/- 0.45 ng/ml by Dixon's up-and-down method. From probit analysis, the EC(50) of remifentanil was 1.37 ng/ml (95% confidence limits, 0.69-2.15 ng/ml), and the EC(95) was 3.19 ng/ml (95% confidence limits, 2.31-11.24 ng/ml). The EC(50) of remifentanil to blunt the withdrawal responses to rocuronium injection was 1.37-1.5 ng/ml during 3 microg/ml propofol TCI anesthesia.

References

Jan 1, 1991·Neuroscience and Biobehavioral Reviews·W J Dixon
Jan 1, 1980·Annual Review of Pharmacology and Toxicology·W J Dixon
Dec 9, 1997·British Journal of Anaesthesia·A Borgeat, D Kwiatkowski
Mar 26, 2003·European Journal of Anaesthesiology·J A BlunkW Koppert
Oct 27, 2006·British Journal of Anaesthesia·J Y KimH J Kwak
May 3, 2008·Yonsei Medical Journal·Byung In ChoiKi-Young Lee

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Citations

Jul 10, 2014·Korean journal of anesthesiology·Hye Jin ParkJeong Sung Seo
Jan 2, 2013·Korean journal of anesthesiology·Bo-Won LeeKeum-Young So
Feb 13, 2016·The Cochrane Database of Systematic Reviews·Hemanshu PrabhakarMartha A Smith

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