Effects of different doses of remifentanil on the end‐tidal concentration of sevoflurane required for tracheal intubation in children

Abstract

SummaryWe investigated the effects of different doses of remifentanil on the end-tidal concentration of sevoflurane required for tracheal intubation in children without the use of neuromuscular blocking drugs. One hundred and thirty paediatric patients, aged 3-8 years, were randomly allocated to receive no remifentanil (group control) or remifentanil 0.1 lg.kgwere anaesthetised using 5% sevoflurane. After loss of eyelash reflex, remifentanil 1 lg.kg )1 was injected over 1 min followed by an appropriate group-dependent infusion and the end-tidal sevoflurane concentration was changed. Predetermined end-tidal sevoflurane concentrations for each group were determined using the Dixon up-and-down method. After the target concentration of sevoflurane was maintained for 5 min, the child's trachea was intubated. Successful intubation was defined as excellent or good intubating conditions. The end-tidal concentration (SD) of sevoflurane for successful tracheal intubation in 50% of children (ED 50 ) were 5.

Management of the airway without the use of neuromuscular blocking agents: the use of remifentanil

“…A very interesting clinical trial was performed by He et al [51] to prove that different doses of remifentanil have an effect on the end-tidal concentration of sevoflurane required for tracheal intubation in children. A very interesting clinical trial was performed by He et al [51] to prove that different doses of remifentanil have an effect on the end-tidal concentration of sevoflurane required for tracheal intubation in children.…”

“…sevoflurane in 50% nitrous oxide (N 2 O) and remifentanil (2 lg/kg) could provide tracheal intubating conditions as excellent as with the use of neuromuscular blockage. A very interesting clinical trial was performed by He et al [51] to prove that different doses of remifentanil have an effect on the end-tidal concentration of sevoflurane required for tracheal intubation in children. They conducted an inhaled induction of anesthesia with 5% sevoflurane in 130 patients, 3-8 years of age.…”

Intubating conditions and adverse events during sevoflurane induction in infants

“…19 Remifentanil has also demonstrated its effectiveness, but it caused significant haemodynamic effects and required previous injection of atropine. 5 In the present study, the addition of alfentanil (20 mg kg 21 ), which is commonly used to intubate, 20 did not significantly improve intubating conditions and did not reduce the incidence of respiratory adverse events, but it increased the number of haemodynamic events (Table 4).…”

Anaesthesia and peri-interventional morbidity of rigid bronchoscopy: A retrospective analysis

“…Remifentanil is an ultra-short acting opioid and works synergistically with both propofol and volatile agents such as sevoflurane in ablating the response to laryngoscopy [13,14]. With the myriad of other pharmacological agents to achieve the same haemodynamic suppression to laryngoscopy, the choice of remifentanil may be hindered by cost, need for specialised pumps and familiarity of use.…”