Effect of sex differences in remifentanil requirements for inhibiting the response to a CO2 pneumoperitoneum during propofol anesthesia: an up-and-down sequential allocation trial

作者：Cheng‐Wei Yang, Yuanyuan Feng, Sheng Wang, Mingming Han, Song Wang, Fang Kang, Xiang Huang, Juan Li · 发表于：BMC Anesthesiology · 年份：2020 · DOI：10.1186/s12871-020-0951-z · 被引用次数：8 · 研究领域：Abdominal Surgery and Complications、Anesthesia and Sedative Agents、Thermal Regulation in Medicine

Abstract Background A CO 2 pneumoperitoneum during a laparoscopic procedure causes violent hemodynamic changes. However, the remifentanil required to inhibit the cardiovascular response to a CO 2 pneumoperitoneum combined with propofol remains unknown. Moreover, the sex of the patient may influence the response to opioids, which can affect this requirement. The main objective of this study was to compare the required median effective concentration (EC 50 ) of remifentanil for inhibiting the cardiovascular response to a CO 2 pneumoperitoneum between female and male patients during propofol anesthesia. Methods The current study is an up-and-down sequential allocation trial. Forty-six patients with American Society of Anesthesiologists physical status I or II, a body mass index 18 to 30 kg/m 2 , aged 20 to 60 years, and scheduled for laparoscopic surgery were enrolled. Induction of anesthesia was performed by target-controlled infusion. The effective effect-site concentration (Ce) of propofol was 4 μg/ml. The Ce of remifentanil was initially 4 ng/ml and then adjusted to a predetermined level after I-gel laryngeal mask airway insertion. The Ce of remifentanil for each patient was determined by the response of the previous patient using the modified Dixon “up-and-down” method. The first patient received remifentanil at 5.0 ng/ml Ce, and the step size between patients was 0.5 ng/ml. Results Patients characteristics including age, body mass index, American Society of Anesthesiologis...