Browse > Article

EC50 of Remifentanil to Prevent Propofol Injection Pain  

Hong, Hun Pyo (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University)
Ko, Hyun Min (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University)
Yoon, Ji Young (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University)
Yoon, Ji Uk (Department of Anesthesia and Pain Medicine School of Medicine, Pusan National University)
Park, Kun Hyo (Department of Oral and Maxillofacial Surgery School of Dentistry, Pusan National University)
Roh, Young Chea (Department of Oral and Maxillofacial Surgery School of Dentistry, Pusan National University)
Publication Information
Journal of The Korean Dental Society of Anesthesiology / v.13, no.3, 2013 , pp. 89-94 More about this Journal
Background: Various strategies have been studied to reduce the propofol injection pain. This study was designed to find out effect-site target concentration (Ce) of remifentanil at which there was a 50% probability of preventing the propofol injection pain (EC50). Methods: Anesthesia was induced with a remifentanil TCI (Minto model). The Ce of remifentanil for the first patient started from 2.0 ng/ml. The Ce of remifentanil for each subsequent patient was determined by the response of the previous patient by Dixon up-and-down method with the interval of 0.5 ng/ml. After the remifentanil reached target concentrations, propofol was administered via a target-controlled infusion system based on a Marsh pharmacokinetic model using a TCI device (Orchestra$^{(R)}$; Fresenius-Vial, Brezins, France). The dose of propofol was effect site target-controlled infusion (TCI) of $3{\mu}g/ml$. Results: The EC50 of remifentanil to prevent the propofol injection pain was $1.80{\pm}0.35ng/ml$ by Dixon's up and down method. Conclusions: The EC50 of remifentanil to blunt the pain responses to propofol injection was $1.80{\pm}0.35ng/ml$ for propofol TCI anesthesia.
Injection; Pain; Propofol; Remifentanil;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Scott RP, Saunders DA, Norman J: Propofol: Clinical strategies for preventing the pain of injection. Anaesthesia 1988; 43: 492-4.   DOI
2 Klement W, Arndt JO: Pain on injection of propofol: Effects of concentration and diluent. Br J Anaesth 1991; 67: 281-4.   DOI
3 Liljeroth E, Grauers A, Akeson J: Pain on injection of propofol with or without infusion of carrier fluid. Acta Anaesthesiol Scand 2001; 45: 839-41.   DOI
4 Fletcher JE, Seavell CR, Bowen DJ: Pretreatment with alfentanil reduces pain caused by propofol. Br J Anaesth 1994; 72: 342-4.   DOI
5 Stokes DN, Robson N, Hutton P: Effect of diluting propofol on the incidence of pain on injection and venous sequelae. Br J Anaesth 1989; 62: 202-3.   DOI
6 Nathanson MH, Gajraj NM, Russell JA: Prevention of pain on injection of propofol: A comparison of lidocaine with alfentanil. Anesth Analg 1996; 82: 469-71.
7 Helmers JH, Kraaijenhagen RJ, v Leeuwen L, Zuurmond WW: Reduction of pain on injection caused by propofol. Can J Anaesth 1990; 37: 267-8.   DOI
8 James MK, Feldman PL, Schuster SV, Bilotta JM, Brackeen MF, Leighton HJ: Opioid receptor activity of GI 87084B, a novel ultra-short acting analgesic, in isolated tissues. J Pharmacol Exp Ther 1991; 259: 712-8.
9 Glass PS, Gan TJ, Howell S: A review of the pharmacokinetics and pharmacodynamics of remifentanil. Anesth Analg 1999; 89: S7-14.
10 Picard P, Tramer MR: Prevention of pain on injection with propofol: A quantitative systematic review. Anesth Analg 2000; 90: 963-9.   DOI
11 Smith I, White PF, Nathanson M, Gouldson R: Propofol. an update on its clinical use. Anesthesiology 1994; 81: 1005-43.   DOI
12 Tan CH, Onsiong MK: Pain on injection of propofol. Anaesthesia 1998; 53: 468-76.   DOI
13 Sethi N, Jayaraman L, Sethi M, Sharma S, Sood J: Prevention of propofol pain: a comparative study. Middle East J Anesthesiol. 2009;20(1):71-4.
14 Larsen B, Beerhalter U, Biedler A, Brandt A, Doege F, Brun K, et al: Less pain on injection by a new formulation of propofol? A comparison with propofol LCT. Anaesthesist 2001; 50: 842-5.   DOI
15 Macario A, Weinger M, Truong P, Lee M: Which clinical anesthesia outcomes are both common and important to avoid? the perspective of a panel of expert anesthesiologists. Anesth Analg 1999; 88: 1085-91.
16 Iwama H, Nakane M, Ohmori S, Kaneko T, Kato M, Watanabe K, et al: Nafamostat mesilate, a kallikrein inhibitor, prevents pain on injection with propofol. Br J Anaesth 1998; 81: 963-4.   DOI
17 Rau J, Roizen MF, Doenicke AW, O'Connor MF, Strohschneider U: Propofol in an emulsion of long- and medium-chain triglycerides: The effect on pain. Anesth Analg 2001; 93: 382,4 , 3rd contents page.
18 Iyilikci L, Balkan BK, Gokel E, Gunerli A, Ellidokuz H: The effects of alfentanil or remifentanil pretreatment on propofol injection pain. J Clin Anesth 2004; 16: 499-502.   DOI
19 Roehm KD, Piper SN, Maleck WH, Boldt J: Prevention of propofol-induced injection pain by remifentanil: A placebo-controlled comparison with lidocaine. Anaesthesia 2003; 58: 165-70.   DOI
20 Basaranoglu G, Erden V, Delatioglu H, Saitoglu L: Reduction of pain on injection of propofol using meperidine and remifentanil. Eur J Anaesthesiol 2005; 22: 890-2.   DOI
21 Minto CF, Schnider TW, Egan TD, Youngs E, Lemmens HJ, Gambus PL, et al: Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. I. model development. Anesthesiology 1997; 86: 10-23.   DOI
22 Parmar AK, Koay CK: Pain on injection of propofol. A comparison of cold propofol with propofol premixed with lignocaine. Anaesthesia 1998; 53: 79-83.   DOI
23 Doenicke AW, Roizen MF, Rau J, Kellermann W, Babl J: Reducing pain during propofol injection: The role of the solvent. Anesth Analg 1996; 82: 472-4.
24 Shafer SL, Gregg KM: Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump. J Pharmacokinet Biopharm 1992; 20: 147-69.   DOI
25 Schnider TW, Minto CF, Gambus PL, Andresen C, Goodale DB, Shafer SL, et al: The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology 1998; 88: 1170-82.   DOI