Journal of Dental Anesthesia and Pain Medicine

  • 제18권5호
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  • Pages.295-300
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  • 2018
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  • 2383-9309(pISSN)
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  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
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Optimal effective-site concentration of remifentanil for sedation during plate removal of maxilla

  • Park, Jeong-Hoon (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Yoon, Ji-Young (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Kim, Eun-Jung (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Yoon, Ji-Uk (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Choi, Byung-Moon (Department of Anesthesiology and Pain Medicine, Asan Medical Centre, University of Ulsan College of Medicine) ;
  • Ahn, Ji-Hye (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute)
  • 투고 : 2018.10.03
  • 심사 : 2018.10.17
  • 발행 : 2018.10.31
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초록

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 ($Ce_{50}$) 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 $1.0{\mu}g/kg$ dexmedetomidine over 10 min, followed by a maintenance dose of $0.7{\mu}g/kg/h$. 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. Conclusion: Plate removal of maxilla can be successfully performed without any pain or adverse effects by using the optimal remifentanil effect-site concentration ($Ce_{50}$, 1.28 ng/mL; $Ce_{95}$, 2.51 ng/mL) combined with sedation using dexmedetomidine.

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참고문헌

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