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Sex-Related Differences in the Effect-Site Concentration of Remifentanil for Preventing QTc Interval Prolongation Following Intubation in Elderly Patients with a Normal QTc Interval

Authors
 S. Y. Kim  ;  M. K. Song  ;  M.-S. Kim  ;  E. H. Kim  ;  D. W. Han 
Citation
 Drugs & Aging, Vol.31(9) : 695-702, 2014 
Journal Title
 Drugs & Aging 
ISSN
 1170-229X 
Issue Date
2014
Abstract
BACKGROUND: Female sex and age more than 65 years are common risk factors for the development of torsades de pointes in association with heart rate-corrected QT (QTc) interval prolongation, which can be induced by tracheal intubation during general anaesthesia. However, the administration of remifentanil can prevent intubation-induced QTc interval prolongation. We compared sex-related differences in the effect-site concentration (Ce) of remifentanil for preventing QTc interval prolongation among elderly patients. METHODS: Twenty-two female and 22 male patients older than 65 years were enrolled. Anaesthesia was induced with remifentanil and propofol using a target-controlled infusion. The Ce of remifentanil for maintaining a QTc interval prolongation <15 ms following intubation was determined for each sex using the isotonic regression method and a bootstrapping approach following Dixon's up-and-down method. RESULTS: The Ce of remifentanil for preventing QTc interval prolongation following intubation in 50 % of the population (EC50) and 95 % of the population (EC95) were significantly lower in females than in males. Isotonic regression revealed that the EC50 (83 % confidence interval) of remifentanil was 3.50 (2.95-4.08) ng/mL in females and 4.38 (4.08-4.63) ng/mL in males. The EC95 (95 % confidence interval) of remifentanil was 4.43 (4.25-4.48) ng/mL in females and 4.94 (4.78-4.98) ng/mL in males. CONCLUSIONS: Target-controlled infusion of remifentanil is effective in attenuating QTc interval prolongation after intubation among elderly patients and the Ce of remifentanil is lower in females than in males.
Full Text
http://link.springer.com/article/10.1007%2Fs40266-014-0198-9
DOI
10.1007/s40266-014-0198-9
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Song, Mi Kyung(송미경)
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99604
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