• Hua-Cheng Liu, Wei-Ke Tao, Rui-Feng Zeng, Wang-Ning ShangGuang, Jun Li, Wen-Guang Huang, Zhang-Lei Dong, Xin Wang, and Qing-Quan Lian.
• Department of Anesthesiology, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
• Paediatr Anaesth. 2014 May 1; 24 (5): 505-9.

BackgroundThe objective of this study was to determine ED50 and ED95 of remifentanil for intubation combined with propofol in nonparalyzed Chinese children.MethodsForty-seven American Society of Anesthesiologists Class I children aged 4-11 years weighing 14-33.5 kg underwent general anesthesia with 2.5 mg·kg(-1) of intravenous propofol followed by remifentanil in Wenzhou, China. The initial dose of remifentanil was 2.5 μg·kg(-1) injected over 60 s. Intubation was attempted 30 s after the completion of remifentanil injection. Level of difficulty to intubate was graded on a scoring system. If the initial intubation condition was deemed satisfactory, subsequent remifentanil doses were decreased by 0.25 μg·kg(-1). If the intubating condition was deemed unsatisfactory, subsequent remifentanil doses were increased by 0.25 μg·kg(-1). Mean arterial pressure, heart rate, and pulse oximetry were documented before and after induction, immediately after intubation, and 1 min after intubation.ResultsThe ED50 of remifentanil used to render a satisfactory intubating condition used in combination with 2.5 mg·kg(-1) of propofol in nonparalyzed Chinese children was 2.30 μg·kg(-1) (95% confidence interval: 2.28-2.31 μg·kg(-1)), and the ED95 is 2.75 μg·kg(-1) (95% confidence interval: 2.59-3.35 μg·kg(-1)). These doses were lower than previously reported.ConclusionWhen used in combination with 2.5 mg·kg(-1) of intravenous propofol, ED50 and ED95 of remifentanil for adequate intubation in nonparalyzed children were lower than previously reported, at 2.30 and 2.75 μg·kg(-1), respectively.© 2014 John Wiley & Sons Ltd.

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