Seong Heon Lee1, Soo Eun Lee1, Shiyoung Chung1, Hyun Jung Lee1, Seongwook Jeong2. 1. Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, South Korea. 2. Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, South Korea. Electronic address: anesman@gmail.com.
Abstract
STUDY OBJECTIVE: To determine the most effective time interval between remifentanil and propofol (TimeRP) for the prevention of propofol injection pain in association with remifentanil dosage. DESIGN: Prospective randomized study. SETTING: Operating room of a university hospital. PATIENTS: Sixty American Society of Anesthesiologists physical status 1 and 2 patients scheduled for elective surgery under general anesthesia. INTERVENTIONS: Patients were randomly assigned to 1 of 3 groups to receive remifentanil at dosages of 0.25, 0.5, or 0.75 μg/kg over 30 seconds before the injection of 1% propofol 2 mg/kg. TimeRP was defined as the time interval from the initiation of the remifentanil injection to the initiation of the propofol injection. TimeRP for each subsequent patient was determined by the response of the previous patient using an up-and-down sequential allocation method. Injection pain caused by propofol was evaluated using a 4-point scale during the propofol injection. MEASUREMENTS: TimeRP50 was defined as the TimeRP at which propofol injection pain was absent in 50% of patients, and it was estimated using isotonic regression for each dose group. MAIN RESULTS:TimeRP50 was significantly lower in the remifentanil 0.75 μg/kg group (38.6 seconds, 83% confidence interval [CI], 35.6-45.0) than in the 0.5 μg/kg group (65.0 seconds; 83% CI, 52.5-75.0) or the 0.25 μg/kg group (66.6 seconds; 83% CI, 57.1-76.5). CONCLUSIONS: The efficacy of remifentanil pretreatment for preventing propofol injection pain can be influenced by the time interval between remifentanil and propofol as well as the remifentanil dose.
RCT Entities:
STUDY OBJECTIVE: To determine the most effective time interval between remifentanil and propofol (TimeRP) for the prevention of propofol injection pain in association with remifentanil dosage. DESIGN: Prospective randomized study. SETTING: Operating room of a university hospital. PATIENTS: Sixty American Society of Anesthesiologists physical status 1 and 2 patients scheduled for elective surgery under general anesthesia. INTERVENTIONS:Patients were randomly assigned to 1 of 3 groups to receive remifentanil at dosages of 0.25, 0.5, or 0.75 μg/kg over 30 seconds before the injection of 1% propofol 2 mg/kg. TimeRP was defined as the time interval from the initiation of the remifentanil injection to the initiation of the propofol injection. TimeRP for each subsequent patient was determined by the response of the previous patient using an up-and-down sequential allocation method. Injection pain caused by propofol was evaluated using a 4-point scale during the propofol injection. MEASUREMENTS: TimeRP50 was defined as the TimeRP at which propofol injection pain was absent in 50% of patients, and it was estimated using isotonic regression for each dose group. MAIN RESULTS: TimeRP50 was significantly lower in the remifentanil 0.75 μg/kg group (38.6 seconds, 83% confidence interval [CI], 35.6-45.0) than in the 0.5 μg/kg group (65.0 seconds; 83% CI, 52.5-75.0) or the 0.25 μg/kg group (66.6 seconds; 83% CI, 57.1-76.5). CONCLUSIONS: The efficacy of remifentanil pretreatment for preventing propofol injection pain can be influenced by the time interval between remifentanil and propofol as well as the remifentanil dose.
Authors: Jae Chul Koh; Juyeon Park; Na Young Kim; Ann Hee You; Seo Hee Ko; Dong Woo Han Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817