Response of Arterial Mechanical Impedance to Different Concentrations of Remifentanil during Abdominal Laparoscopic Colectomy
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A specific and reliable method for monitoring analgesia during general anesthesia is urgently required. Previously, we introduced a method that indicates arterial mechanical properties for estimating arterial wall stiffness (K). However, whether the response of K actually indicates changes in remifentanil target concentrations under continuous surgical stress, is unclear. Thus, we aimed to evaluate how K responds to different remifentanil target concentrations.
This prospective study enrolled 30 patients who underwent laparoscopic colectomy. The patients received 3 different effect-site concentrations (2, 4, and 6 ng/ml) of remifentanil 3 times during the study period. The K values at 4-ng/ml administration were used as control values (Kcontrol). K values at 6-ng/ml administration (K6ng) and those at 2-ng/ml administration (K2ng) were normalized by dividing them by the control values. The results showed that K responded to the changes in remifentanil concentration, significantly decreasing at 6-ng/ml remifentanil effect-site concentration and increasing at 2-ng/ml concentration. The stress response at low analgesia was higher than that at high analgesia, and, as predicted, normalized K2ng was significantly greater than normalized K6ng. In conclusion, we found that K is a sensitive stress response monitor and dynamically responds to changes in remifentanil concentration in invasive stimulation during laparoscopic colectomy.
Hiroshima Journal of Medical Sciences
Hiroshima University Medical Press
Copyright (c) 2018 Hiroshima University Medical Press
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