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The optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery.

DC Field Value Language
dc.contributor.author장철호-
dc.contributor.author곽영란-
dc.contributor.author송종욱-
dc.contributor.author심연희-
dc.contributor.author이종화-
dc.date.accessioned2014-12-19T17:28:01Z-
dc.date.available2014-12-19T17:28:01Z-
dc.date.issued2012-
dc.identifier.issn0375-9393-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/91461-
dc.description.abstractBACKGROUND: Remifentanil has been suggested as a suitable agent for conscious sedation during fibreoptic intubation. We evaluated the optimal effect site concentration (Ce) of remifentanil target-controlled infusion (TCI) for awake nasotracheal fibreoptic intubation in patients undergoing elective cervical spine surgery. METHODS: Nineteen ASA I-II patients were enrolled. Patients were premedicated with midazolam (<70 kg 1.5 mg; >70 kg 2.0 mg) intravenously. The EC(50) and EC(95) of remifentanil Ce for smooth intubation were determined using Dixon's up-and-down method and isotonic regression. Smooth intubation was considered to have failed when patients exhibited sustained and repetitive coughing with head lift during the procedure. Intubation time, number of attempts, adverse events, and hemodynamic variables were also recorded. Patients were asked to recall the procedure and grade satisfaction at postoperative 24 h. RESULTS: The EC(50) of remifentanil Ce for smooth intubation was 2.33±0.38 ng·mL-1 as calculated by Dixon's method. The estimated EC(95) of remifentanil Ce was 3.38 (95% confidence interval 2.90-3.46) ng·mL-1. Median intubation time (min) was longer in failed smooth intubation than in smooth intubation (8.0 vs. 6.1, P=0.048). Eleven patients (58%) recalled the procedure and 16 patients (84%) rated their satisfaction score as good or excellent. CONCLUSION: The estimated EC(95) of remifentanil Ce for smooth nasotracheal fibreoptic intubation with conscious sedation was 3.38 (95% CI 2.90-3.46) ng·mL-1 when used in combination with midazolam and topical lidocaine. Remifentanil TCI may provide a tolerable experience of awake fibreoptic intubation despite the high incidence of recall.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfMINERVA ANESTESIOLOGICA-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdministration, Topical-
dc.subject.MESHAnesthetics, Combined/administration & dosage*-
dc.subject.MESHAnesthetics, Intravenous/administration & dosage*-
dc.subject.MESHAnesthetics, Local/administration & dosage*-
dc.subject.MESHCervical Vertebrae/surgery*-
dc.subject.MESHConscious Sedation/methods*-
dc.subject.MESHFemale-
dc.subject.MESHFiber Optic Technology-
dc.subject.MESHHumans-
dc.subject.MESHIntubation, Intratracheal/methods*-
dc.subject.MESHLidocaine/administration & dosage*-
dc.subject.MESHMale-
dc.subject.MESHMidazolam/administration & dosage*-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPiperidines/administration & dosage*-
dc.titleThe optimal effect site concentration of remifentanil in combination with intravenous midazolam and topical lidocaine for awake fibreoptic nasotracheal intubation in patients undergoing cervical spine surgery.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology (마취통증의학)-
dc.contributor.googleauthorSong J. W.-
dc.contributor.googleauthorKwak Y. L.-
dc.contributor.googleauthorLee J. W.-
dc.contributor.googleauthorChang C. H.-
dc.contributor.googleauthorKim H. S.-
dc.contributor.googleauthorShim Y. H.-
dc.identifier.doi22240620-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03485-
dc.contributor.localIdA00172-
dc.contributor.localIdA02060-
dc.contributor.localIdA02196-
dc.contributor.localIdA03154-
dc.relation.journalcodeJ02235-
dc.identifier.eissn1827-1596-
dc.identifier.pmid22240620-
dc.identifier.urlhttp://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2012N05A0521-
dc.subject.keywordAnesthesia-
dc.subject.keywordAnalgesics, opioid-
dc.subject.keywordConscious sedation-
dc.contributor.alternativeNameChang, Chul Ho-
dc.contributor.alternativeNameKwak, Young Lan-
dc.contributor.alternativeNameSong, Jong Wook-
dc.contributor.alternativeNameShim, Yon Hee-
dc.contributor.alternativeNameLee, Jong Wha-
dc.contributor.affiliatedAuthorChang, Chul Ho-
dc.contributor.affiliatedAuthorKwak, Young Lan-
dc.contributor.affiliatedAuthorSong, Jong Wook-
dc.contributor.affiliatedAuthorShim, Yon Hee-
dc.contributor.affiliatedAuthorLee, Jong Wha-
dc.citation.volume78-
dc.citation.number5-
dc.citation.startPage521-
dc.citation.endPage526-
dc.identifier.bibliographicCitationMINERVA ANESTESIOLOGICA, Vol.78(5) : 521-526, 2012-
dc.identifier.rimsid31295-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers

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