{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T03:11:45Z","timestamp":1768533105723,"version":"3.49.0"},"reference-count":27,"publisher":"The Korean Society of Anesthesiologists","issue":"3","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekja.org"],"crossmark-restriction":true},"short-container-title":["Korean J Anesthesiol"],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:p>Background: Remifentanil can be used as adjuvants during remimazolam induction without neuromuscular blockade. We evaluated the 95% effective concentration (EC) of remifentanil effect-site concentration (Ce) for the successful insertion of an i-gel using the biased-coin up-and-down method in adult patients during remimazolam induction.  Methods: Forty 19\u201365 year-old patients scheduled to undergo surgery using i-gel were enrolled. Anesthesia was induced using remimazolam infusion (12 mg\/kg\/h). Simultaneously, remifentanil was infused at a predetermined Ce. After 5 min of anesthesia induction, the i-gel was inserted. The 95% EC (EC95) of remifentanil in each patient was determined using a biased-coin up-and-down method based on a successful insertion in a preceding patient. The step size of remifentanil Ce was 0.4 ng\/ml. If the insertion failed, remifentanil Ce was increased in the next patient. Following successful insertions, the corresponding concentration decreased in subsequent patients with a probability of 1\/19 or was maintained with a probability of 18\/19. The time from remimazolam infusion initiation to a bispectral index (BIS) &lt; 60 (time to BIS60) and hemodynamic variables were measured and recorded.Results: The EC95 (95% CI) of Ce was 2.07 (1.94, 2.87) ng\/ml. The overall time to BIS60 was 154.0 \u00b1 39.9 s. No patient experienced significant hypotension or bradycardia during remimazolam induction.Conclusions: The EC95 of remifentanil Ce was 2.07 (1.94, 2.87) ng\/ml for successful i-gel insertion during remimazolam induction at 12 mg\/kg\/h without hemodynamic instability in adult patients. Future studies should measure remifentanil Ce in elderly patients or using remimazolam at various infusion doses.<\/jats:p>","DOI":"10.4097\/kja.22606","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T08:06:20Z","timestamp":1667203580000},"page":"235-241","update-policy":"https:\/\/doi.org\/10.4097\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effective concentration of remifentanil for successful i-gel insertion during remimazolam induction"],"prefix":"10.4097","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4637-0029","authenticated-orcid":true,"given":"Jung Ju","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8356-4615","authenticated-orcid":true,"given":"Wol 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