Cervical Disc Herniation, Cervical Spinal Stenosis, Cervical Spine Damage
Conditions
Brief summary
Remifentanil provides analgesia, suppresses airway reflex, has little effect on cognitive function. It can be used for conscious sedation during awake nasotracheal fiberoptic intubation. Target-controlled infusion is more reliable technique for maintaining optimal infusion rate than manual controlled infusion. The aim of this study is to determine the effect site concentration of remifentanil for successful conscious sedation during awake nasotracheal fiberoptic intubation.
Interventions
DRUGRemifentanil
After topical airway anesthesia with 10 % lidocaine in nostril and oropharyx, 1.5\ 2.0 mg of IV midazolam is injected. Awake nasotracheal fiberoptic intubation is performed with target-controlled infusion of remifentanil. Initial effect site concentration is 3.0 ng/ml. Smooth intubation is defined as absence of persistent cough with head elevation and defensive movement of extremities. In case of smooth intubation, effect site concentration is decreased by 0.5 ng/ml for the subsequent case. If intubation is not smooth, effect site concentration is increased by 0.5 ng/ml for the subsequent case. EC50 of remifentanil is determined using Dixon's up-and-down method.
Sponsors
Yonsei University
Study design
Primary purpose
PREVENTION
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing cervical spine surgery * Age 20-65 * American Society of Anesthesiologists physical status classification I or II
Exclusion criteria
* Patients' refusal * allergy to any drug used * unable to cooperate * Severe hepatic or renal disease * coagulation disorder * chronic use of opioids or sedatives * increase risk of pulmonary aspiration.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| EC50 of remifentanil for preventing persistent cough and defensive movement using Dixon's up-and-down method | — |
Countries
South Korea
Outcome results
None listed