Remifentanil-TCI and propofol-TCI for conscious sedation during fibreoptic intubation in the acromegalic patient

European Journal of Anaesthesiology
T CafieroP Cappabianca

Abstract

To evaluate the use of remifentanil-propofol administered as target-controlled infusion during awake fibreoptic intubation for anticipated difficult tracheal intubation in acromegalic patients. In all, 20 consecutive acromegalic patients underwent elective endonasal endoscopic transsphenoidal pituitary surgery. After premedication with midazolam 0.03 mg kg(-1), initially a target-controlled infusion of remifentanil 1.0 ng mL(-1) and propofol 1.5 microg mL(-1) was started. The fibreoptic intubation was performed by the same physician experienced with the fibreoptic technique. During the fibreoptic procedure the target concentrations of remifentanil and propofol ranged between 1.0 and 5.0 ng mL(-1), and between 1.5 and 3.5 microg mL(-1), respectively. Changes in heart rate and mean arterial pressure were recorded during airway manipulation, during tracheal intubation, and at 1 and 3 min after. On the first postoperative day, patient recall and level of discomfort during fibreoptic intubation were evaluated. Endotracheal intubation was efficaciously and quickly secured in all patients. A significant increase in mean arterial pressure and heart rate was recorded only during tracheal intubation (P < 0.05). Oxygenation was sufficient...Continue Reading

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Citations

Mar 21, 2013·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Kevin D Johnston, Mridula R Rai
Jul 21, 2011·Fundamental & Clinical Pharmacology·Georgia FotopoulouTheodoros Xanthos
Mar 18, 2015·Experimental and Therapeutic Medicine·Hui-Hui LiuWu-Hua Ma
May 6, 2011·European Journal of Anaesthesiology·Didde T SchnackLars S Rasmussen

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