Optimal effective-site concentration of remifentanil for sedation during plate removal of maxilla
박정훈, 윤지영, 김은정, 윤지욱, 최병문, 안지혜,
소속 상세정보
박정훈 ( Park Jeong-Hoon ) - Pusan National University School of Dentistry Department of Dental Anesthesia and Pain Medicine
윤지영 ( Yoon Ji-Young ) - Pusan National University School of Dentistry Department of Dental Anesthesia and Pain Medicine
김은정 ( Kim Eun-Jung ) - Pusan National University School of Dentistry Department of Dental Anesthesia and Pain Medicine
윤지욱 ( Yoon Ji-Uk ) - Pusan National University School of Medicine Department of Anesthesia and Pain Medicine
최병문 ( Choi Byung-Moon ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
안지혜 ( Ahn Ji-Hye ) - Pusan National University School of Dentistry Department of Dental Anesthesia and Pain Medicine
Abstract
Background: Removal of the plate following Le Fort I osteotomy and BSSO (bilateral sagittal split osteotomy) is a common procedure. However, patients who undergo plate removal experience intense pain and discomfort. This study investigated the half-maximal effective concentration (Ce50) of remifentanil in the prevention of plate removal pain under sedation using dexmedetomidine.
Methods: The study evaluated 18 patients, between 18 and 35 years of age, scheduled for elective surgery. Remifentanil infusion was initiated after sedation using dexmedetomidine, and started at a dose of 1.5 ng/mL on the first patient via target-controlled infusion (TCI). Patients received a loading dose of 1.0 μg/kg dexmedetomidine over 10 min, followed by a maintenance dose of 0.7 μg/kg/h. When the surgeon removed the plate, the patient Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score was observed.
Results: The Ce of remifentanil ranged from 0.9 to 2.1 ng/mL for the patients evaluated. The estimated effect-site concentrations of remifentanil associated with a 50% and 95% probability of reaching MOAA/S score of 3 were 1.28 and 2.51 ng/mL, respectively.
Conclusions: Plate removal of maxilla can be successfully performed without any pain or adverse effects by using the optimal remifentanil effect-site concentration (Ce50, 1.28 ng/mL; Ce95, 2.51 ng/mL) combined with sedation using dexmedetomidine.
키워드
Conscious Sedation, Dexmedetomidine; Plate Removal; Remifentanil
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