The effect of remifentanil on the minimum alveolar concentration of isoflurane in children

Chen, Ben-zhen; Chu, Qinjun; Yu, Jiajie; Yao, Yusheng; Tan, Ling

doi:10.1016/j.jclinane.2015.03.026

Cited by 8 publications

(1 citation statement)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It exhibits a rapid onset of action after intravenous injection, peaking at 15-30 min, with a terminal half-life of approximately 1 h. Although equilibration of the partial pressure of sevo urane in alveolar and brain tissues is usually achieved in approximately 10-15 min, a preset end-tidal sevo urane concentration was chosen to remain stable for at least 15 min. In this study, to adequately block the stress response during intubation and ensure hemodynamic stability during the tracheal intubation stage, the plasma target-controlled concentration of remifentanil was set at 3 ng/ml before intubation in all patients, and the concentration was adjusted to 1 ng/ml immediately after the end of intubation and was maintained for at least 15 min before the establishment of pneumoperitoneum (11). According to the pharmacokinetic and pharmacodynamic characteristics of remifentanil, the effector compartment equilibrium concentration was reached at the time of pneumoperitoneum, effectively reducing the interference of the experiments owing to individual differences.…”

Section: Secondary Outcomementioning

confidence: 99%

Effect of remimazolam on MACBAR of sevoflurane in gynecological laparoscopic surgery: a randomized controlled trial

Huang,

Liao,

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Previously, our study revealed that remimazolam effectively reduces end-expiratory sevoflurane minimum alveolar concentration (MAC) values during laryngeal mask placement in adults. However, the combined effect of remifentanil and sevoflurane in MAC for blocked adrenergic response (MACBAR) remained unclear. In this study, we aimed to investigate the effects of different doses of remimazolam combined with remifentanil on sevoflurane MACBAR in patients undergoing gynecological laparoscopic surgery.Methods Overall, 120 patients, aged 20–45 years, with elective gynecologic laparoscopic surgery and categorized under the American Society of Anesthesiologists grade were selected. They were then randomly categorized into one control group (R0) and three remimazolam groups (R1, R2, and R3), each comprising 30 patients, using a randomized numeric table method. Anesthesia was induced in all patients through intravenous injection of propofol (2 mg/kg), cisatracurium (1.5 mg/kg), and remifentanil (3 ng/ml) via target-controlled infusion. Mechanical ventilation was performed after tracheal intubation, and anesthesia was maintained by inhaling sevoflurane. The plasma concentration of remifentanil was adjusted to 1 ng/mL via target-controlled infusion. Group R0 pumped an equal volume of saline, while groups R1, R2, and R3 continuously pumped remimazolam at 1.0 mg/kg/h, 1.5 mg/kg/h, and 2 mg/kg/h, respectively. The end-expiratory sevoflurane concentration for patients in each group was adjusted to the preset value for at least 20 min. Heart rate and mean arterial pressure were recorded at several time points: before induction of anesthesia, 3 and 1 min before, and 1 and 3 min after pneumoperitoneum induction in all four groups. The sevoflurane MACBAR was determined using sequential and up-and-down methods.Results The MACBAR of sevoflurane in groups R0, R1, R2 and R3 were (2.46 ± 0.18)%, (2.18 ± 0.16)%, (1.81 ± 0.15)% and (1.47 ± 0.18)%, respectively. Compared to the R0 group, the R1, R2, and R3 sevoflurane MACBAR were significantly lower (P < 0.05).Conclusions Remimazolam reduced sevoflurane MACBAR in patients undergoing gynecologic laparoscopic surgery and increased in a dose-dependent manner.

show abstract

Section: Secondary Outcomementioning

confidence: 99%