Effective dose of remifentanil for control of haemodynamic response to insertion of the Streamlined Liner of the Pharyngeal Airway

Abstract

Objective: To determine the dose of remifentanil needed to achieve successful insertion of the Streamlined Liner of the Pharyngeal Airway (SLIPA (TM)) without the development of hypertension in 95% of the patients. Design: Randomised controlled trial. Setting: operating theatre of a university hospital. Methods: A total of 100 ASA I or II patients requiring SLIPA insertion were randomly assigned to receive normal saline (Group C) or one of the four different doses (0.5 mu g/kg [Group R0.5], 1.0 mu g/kg [Group R1], 1.5 mu g/kg [Group R1.5] or 2.0 mu g/kg [Group R-2]) of remifentanil. Arterial blood pressure and heart rate were recorded at preanesthetic baseline, preinserton, and every one minute during the initial 3 minutes period after insertion. Results: A Probit model of remifentanil concentration was predictive of successful insertion of SLIPA without the development of hypertension. The ED95 of remifentanil needed to suppress haemodynamic response from SLIPA insertion was 1.39 mu g/kg (95% confidence interval, 1.06-2.61 mu g/kg). Conclusions: A single administration of remifentanil can effectively suppress haemodynamic changes due to the insertion of SLIPA.