Microemulsion propofol 정주통 예방을 위한 remifentanil EC50 에 대한 연령과 성별의 영향

Abstract

Background: Propofol injection pain is an unpleasant experience of patients and its prevalence can influence on the age and gender. The pretreatment of remifentanil have been reported to reduce the propofol injection pain. In this study, we determined the half maximal effective concentration (EC50) of remifentanil for preventing the microemulsion propofol injection pain in male, female, old and young group. Materials and method: After institutional review board approval, a total of 120 patients was assigned into 4 groups depending on their age and gender; group M (adult male, 20-65 yrs), group F (adult female, 20-65 yrs), group O (age > 65 yrs), and group Y (age 20-65 yrs). Anesthesia was induced with a propofol and remifentanil by target-controlled infusion (TCI). Effect-site target concentration (Ce) of propofol was 4 ug/ml. Ce of remifentanil for the first patient started at 4.0 ng/ml. Ce of remifentanil for each subsequent patient was determined by the response of the previous patient by the Dixon's up-and-down method with an interval of 0.2 ng/ml. After remifentanil reached target concentration, propofol was administered, and the pain response was observed. Results: The remifentanil EC50 was 3.8 ± 0.2, 2.7 ± 0.2, 3.2 ± 0.2,and 3.5 ± 0.1 ng/ml in group M, F, O and Y, respectively, by Dixon's up-and-down method. From probit analysis, the remifentanil EC50 was 3.7 (95% confidence interval(CI), 3.0-4.3), 2.7 (95% CI, 1.8-2.9), 3.1 (95% CI, 2.8-3.4), 3.5 (95% CI, 3.4-3.7) ng/ml in group M, F, O and Y, respectively. Conclusions: The remifentanil EC50 for preventing propofol injection pain was lowest in female, highest in male, and higher in young group than the old group.