Evaluation of remifentanil for control of haemodynamic response to tracheal intubation

D McAtamney, R O'Hare, D Hughes, U Carabine, R Mirakhur
Anaesthesia 1998, 53 (12): 1223-7
We have studied the effect of three bolus doses of remifentanil on the haemodynamic response to laryngoscopy and tracheal intubation. Using a double-blind design, 80 ASA 1 or 2 patients presenting for elective surgery received saline placebo or remifentanil 0.25, 0.5 or 1.0 by random allocation. Anaesthesia was induced with thiopentone 5-7 and followed immediately by the study medication given as a bolus over 30s. Muscle relaxation was provided with rocuronium 0.75 The patients' tracheas were intubated under direct laryngoscopy 1 min later. Noninvasive arterial blood pressure and heart rate were recorded immediately before induction of anaesthesia and then at intervals until 5 min after tracheal intubation. There was a significant increase in heart rate (p < 0.01) and systolic arterial pressure (p < 0.01) in all groups after tracheal intubation. However, this was short-lived and of a smaller magnitude in the remifentanil 1 group in which the increase was significantly lower than in the control group (p < 0.01).

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