Propofol을 이용한 후두마스크 삽입 시 Remifentanil의 효과 = The Effects of Remifentanil on the LMA Insertion with the Administration of Propofol

다국어 초록 (Multilingual Abstract)

Background: Laryngeal mask airway (LMA) can be inserted without
muscle relaxant in patients who have received propofol. Remifentanil
that is recently used opioid effectively attenuates the hemodynamic
responses to laryngoscopy. This study was to investigate
the effects of remifentanil on the quality and hemodynamic response
of LMA insertion after intravenous propofol induction without muscle
relaxant.
Methods: Forty patients (ASA I or II, 20-65 years) were randomly
allocated to control and remifentanil group. Control group received
propofol 4μg/ml alone, remifentanil group received propofol 4μg/ml
and remifetanil 2 ng/ml by target controlled infusion. LMA insertion
condition was assessed by Muzi’s score (jaw mobility, coughing,
movement). The time interval to loss of eyelash reflex, to BIS ＜ 60
and to insertion of LMA were recorded. The BIS and hemodynamic
changes were measured at preinduction (baseline), preinsertion and
postinsertion.
Results: Loss of consciousness and LMA insertion were more rapid
with remifentanil group than control group (P ＜ 0.05). Clinically
acceptable insertion of LMA were observed in 35% and 70% of
patients in the control and remifentanil group, respectively. There
were significant elevations in heart rate, mean blood pressure after
insertion of LMA in control group, but no elevations in remifentanil
group. And there were no significant differences in BIS in both
groups.
Conclusions: The LMA insertion with propofol-remifentanil can
provide more favorable condition and stable hemodynamic status compared with propofol alone.