Evaluation of remifentanil for control of haemodynamic response to tracheal intubation

We have studied the effect of three bolus doses of remifentanil on the haem odynamic response to laryngoscopy and tracheal intubation. Using a double-b lind design, 80 ASA I or 2 patients presenting for elective surgery receive d saline placebo or remifentanil 0.25, 0.5 or 1.0 mu g.kg(-1) by random all ocation. Anaesthesia was induced with thiopentone 5-7 mg.kg(-1) and followe d immediately by the study medication given as a bolus over 30s. Muscle rel axation was provided with rocuronium 0.75 mg.kg(-1). The patients' tracheas were intubated under direct laryngoscopy 1 min later. Noninvasive arterial blood pressure and heart rate were recorded immediately before induction o f anaesthesia and then at intervals until 5 min after tracheal intubation. There was a significant increase in heart rate (p < 0.01) and systolic arte rial pressure (p < 0.01) in all groups after tracheal intubation. However, this was short-lived and of a smaller magnitude in the remifentanil 1 mu g. kg(-1) group in which the increase was significantly lower than in the cont rol group (p < 0.01).