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Anesthetic Pharmacology
Anesthesia and Pain Medicine 2007;2(1):9-13.
Published online January 30, 2007.
The Effects of Remifentanil on the LMA Insertion with the Administration of Propofol
Heung Ki Kim, Seong Wook Choi, Hye Won Shin, Hye Won Lee, Hae Ja Lim, Seok Min Yoon, Seong Ho Chang
Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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 4microg/ml alone, remifentanil group received propofol 4microg/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.
Key Words: laryngeal mask airway, propofol, remifentanil

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