Predicting the optimal concentration of remifentanil for skull pin fixation with hemodynamic and analgesia nociception index monitoring
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View abstract on PubMed
Summary
This summary is machine-generated.The 90% effective concentration of remifentanil for skull pin fixation was determined to be 4.7 ng/ml. This ensures adequate antinociception and hemodynamic stability during intracranial surgery.
Area Of Science
- Anesthesiology
- Neurosurgery
- Pharmacology
Background
- Skull pin fixation during intracranial surgery can lead to hemodynamic instability due to inadequate antinociception.
- Optimal remifentanil concentration for maintaining antinociception and hemodynamic stability during this procedure is not well-established.
Purpose Of The Study
- To determine the 90% effective concentration (EC90) of remifentanil for skull pin fixation.
- To assess remifentanil's efficacy in providing adequate antinociception and hemodynamic stability using the Analgesia Nociception Index (ANI) and hemodynamic monitoring.
Main Methods
- Twenty-six patients undergoing intracranial surgery received total intravenous anesthesia with remifentanil and propofol.
- Dixon's up-and-down method was employed to determine remifentanil EC90, with adjustments based on ANI and hemodynamic parameters (heart rate, blood pressure).
- Adequate antinociception was defined as ANI > 30 and hemodynamic changes < 20% from baseline.
Main Results
- The calculated 90% effective concentration of remifentanil was 4.7 ng/ml.
- This concentration was associated with adequate antinociception and hemodynamic stability during skull pin fixation.
Conclusions
- The study identified a specific remifentanil concentration (4.7 ng/ml) for effective antinociception and hemodynamic control during skull pin fixation.
- This finding aids in optimizing anesthetic management for intracranial procedures requiring skull pin fixation.
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