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Reduction of pain during induction with target-controlled propofol and remifentanil

Cited 26 time in Web of Science Cited 29 time in Scopus
Authors
Lee, J. R.; Jung, C. W.; Lee, Y. H.
Issue Date
2007-11-17
Publisher
Oxford University Press
Citation
Br J Anaesth. 2007 Dec;99(6):876-80.
Keywords
AdolescentAdultAgedAnalgesics, Opioid/adverse effects/*therapeutic useAnesthetics, Intravenous/administration & dosage/*adverse effectsDouble-Blind MethodDrug Delivery SystemsFemaleHumansInfusions, Intravenous/adverse effectsMaleMiddle AgedPain/etiology/*prevention & controlPain Measurement/methodsPiperidines/adverse effects/*therapeutic usePropofol/administration & dosage/*adverse effectsProspective Studies
Abstract
BACKGROUND: Pain on injection of propofol is unpleasant. We hypothesized that propofol infusion pain might be prevented by infusing remifentanil before starting the propofol infusion in a clinical setting where target-controlled infusions (TCI) of both drugs were used. A prospective, randomized, double-blind, placebo-controlled trial was performed to determine the effect-site concentration (Ce) of remifentanil to prevent the pain without producing complications. METHODS: A total of 128 patients undergoing general surgery were randomly allocated to receive normal saline (control) or remifentanil to a target Ce of 2 ng ml(-1) (R2), 4 ng ml(-1) (R4), or 6 ng ml(-1) (R6) administered via TCI. After the target Ce was achieved, the infusion of propofol was started. Remifentanil-related complications were assessed during the remifentanil infusion, and pain caused by propofol was evaluated using a four-point scale during the propofol infusion. RESULTS: The incidence of pain was significantly lower in Groups R4 and R6 than in the control and R2 groups (12/32 and 6/31 vs 26/31 and 25/32, respectively, P<0.001). Pain was less severe in Groups R4 and R6 than in the control and R2 groups (P<0.001). However, both incidence and severity of pain were not different between Groups R4 and R6. No significant complications were observed during the study. CONCLUSIONS: During induction of anaesthesia with TCI of propofol and remifentanil, a significant reduction in propofol infusion pain was achieved without significant complications by prior administration of remifentanil at a target Ce of 4 ng ml(-1).
ISSN
1471-6771 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18006530

http://hdl.handle.net/10371/24697
DOI
https://doi.org/10.1093/bja/aem293
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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