Korean J Anesthesiol Search

CLOSE


Korean Journal of Anesthesiology 2006;51(3):292-296.
DOI: https://doi.org/10.4097/kjae.2006.51.3.292   
Optimal Dose of Remifentanil to Blunt Hemodynamic Response to Laryngoscopy and Endotracheal Intubation during Induction of Anesthesia with Propofol.
Jin Wook Cha, Sang Hyun Kwak, Seok Jai Kim, Jeong Il Choi, Chang Mo Kim, Sung Tae Jeong, Kyung Yeon Yoo
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea. kyyoo@chonnam.ac.kr
Abstract
BACKGROUND
A laryngoscopy and endotracheal intubation cause an increase in the blood pressure and heart rate. Remifentanil is an opioid that is often used to reduce the hemodynamic responses after tracheal intubation. This study evaluated the effect of three bolus doses of remifentanil on the hemodynamic responses to a laryngoscopy and tracheal intubation.
METHODS
Eighty patients, aged 35-65 years, with an ASA physical status of I and II were randomly divided into four groups containing 20 patients each. Anesthesia was induced with propofol 2 mg/kg followed 30 s later by saline (control) or remifentanil 0.5 (R0.5), 1 (R1) or 2 (R2)microgram/kg given as a bolus over a 30 s period. A laryngoscopy and tracheal intubation were performed 90 s later (corresponding to 3 min after induction), and anesthesia was maintained using 2% sevoflurane and 50% nitrous oxide in oxygen. Rocuronium 1 mg/kg was given as a neuromuscular block. The systolic arterial blood pressure (SAP) and heart rate (HR) were recorded until 5 min after intubation.
RESULTS
In all groups, the SAP decreased after inducing anesthesia and then increased after intubation in all groups (P < 0.05), but the maximum increases (46, 15, and 9 mmHg in the R0.5, R1, and R2 groups, respectively) after intubation were lower in the remifentanil groups than that of the control group (73 mmHg) (P < 0.05). The HR decreased in the remifentanil groups while it remained stable in the controls after the induction of anesthesia. However, it increased after intubation in all groups. The mean maximum HR (83, 71, and 69 bpm in the R0.5, R1 and R2 groups, respectively) was significantly lower in the remifentanil groups than that in the controls (98 bpm) (P < 0.05). All remifentanil doses significantly attenuated the pressor and tachycardiac responses (P < 0.05).
CONCLUSIONS
All remifentanil doses were effective in controlling the pressor and tachycardiac response to endotracheal intubation in patients in whom anesthesia was induced with propofol. However, the use of the 1 and 2microgram/kg dose was associated with a decrease in the SAP to less than 85 mm Hg in 10 patients (50%) each. Therefore, 0.5microgram/kg appears to be the optimal dose to attenuate the cardiovascular responses to endotracheal intubation in patients.
Key Words: hemodynamic changes; propofol; remifentanil


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
101-3503, Lotte Castle President, 109 Mapo-daero, Mapo-gu, Seoul 04146, Korea
(서울특별시 마포구 마포대로 109 롯데캐슬 프레지던트 101동 3503호)
Tel: +82-2-792-5128    Fax: +82-2-792-4089    E-mail: journal@anesthesia.or.kr                
Business Name: Korean Society of Anesthesiologists (대한마취통증의학회)
Business Registration: 106-82-07194
Representative: Jun Heum Yon (연준흠)

Copyright © 2024 by Korean Society of Anesthesiologists.

Developed in M2PI

Close layer
prev next