Abstract

BackgroundA CO2 pneumoperitoneum during a laparoscopic procedure causes violent hemodynamic changes. However, the remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum combined with propofol remains unknown. Moreover, the sex of the patient may influence the response to opioids, which can affect this requirement. The main objective of this study was to compare the required median effective concentration (EC50) of remifentanil for inhibiting the cardiovascular response to a CO2 pneumoperitoneum between female and male patients during propofol anesthesia.MethodsThe current study is an up-and-down sequential allocation trial. Forty-six patients with American Society of Anesthesiologists physical status I or II, a body mass index 18 to 30 kg/m2, aged 20 to 60 years, and scheduled for laparoscopic surgery were enrolled. Induction of anesthesia was performed by target-controlled infusion. The effective effect-site concentration (Ce) of propofol was 4 μg/ml. The Ce of remifentanil was initially 4 ng/ml and then adjusted to a predetermined level after I-gel laryngeal mask airway insertion. The Ce of remifentanil for each patient was determined by the response of the previous patient using the modified Dixon “up-and-down” method. The first patient received remifentanil at 5.0 ng/ml Ce, and the step size between patients was 0.5 ng/ml.ResultsPatients characteristics including age, body mass index, American Society of Anesthesiologists physical status, type of surgery and surgery duration, were comparable between male and female patients. The EC50 of remifentanil required to inhibit the response to a CO2 pneumoperitoneum based on the Dixon “up-and-down” method in women (4.17 ± 0.38 ng/ml) was significantly lower than that in men (5.00 ± 0.52 ng/ml) during propofol anesthesia (P = 0.01).ConclusionsThe EC50 of remifentanil required to inhibit the response to a CO2 pneumoperitoneum was lower in women than in men during propofol anesthesia.Trial registrationThe study was registered at http://www.chictr.org.cn (ChiCTR-IOR-17011906, 8th, July, 2017).

Highlights

  • A CO2 pneumoperitoneum during a laparoscopic procedure causes violent hemodynamic changes

  • There have been several studies investigating the median effective concentration (EC50) of remifentanil during propofol anesthesia in different situations [9,10,11], the remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum combined with propofol remains unknown

  • The present study demonstrated that the Median effective concentration (EC50) of remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum in women (4.17 ± 0.38 ng/ ml) was lower than that in men (5.00 ± 0.52 ng/ml) during propofol anesthesia

Read more

Summary

Introduction

A CO2 pneumoperitoneum during a laparoscopic procedure causes violent hemodynamic changes. The remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum combined with propofol remains unknown. The main objective of this study was to compare the required median effective concentration (EC50) of remifentanil for inhibiting the cardiovascular response to a CO2 pneumoperitoneum between female and male patients during propofol anesthesia. Remifentanil has a very short infusion time-related half-life and is suitable for continuous infusion [6] It can inhibit the stress reaction effectively. There have been several studies investigating the median effective concentration (EC50) of remifentanil during propofol anesthesia in different situations [9,10,11], the remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum combined with propofol remains unknown

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call