EFFECT OF REMIFENTANIL ON THE AUDITORY-EVOKED RESPONSE AND HEMODYNAMIC-CHANGES AFTER INTUBATION AND SURGICAL INCISION

We have observed the effect of intubation and incision, as measured by the auditory evoked response (AER) and haemodynamic variables, in 12 patients undergoing hernia repair or varicose vein surgery who receive d remifentanil as part of either an inhaled anaesthetic technique usin g isoflurane or as pa rt of a total i.v. technique using propofol. Ana esthesia was induced with remifentanil 1 mu g kg(-1) and propofol, neu romuscular block was achieved with atracurium 0.6 mg kg(-1) before int ubation, and anaesthesia was maintained with a continuous infusion of remifentanil in combination with either a continuous infusion of propo fol or inhaled isoflurane. The AER and haemodynamic variables were mea sured before and after intubation and incision. The effects of intubat ion and incision on the AER and haemodynamic variables were not signif icantly different between the remifentanil-propofol and remifentanil-i soflurane groups. However, the study had a low power for this comparis on. When the data for the two anaesthetic combinations were pooled, th e only significant effects were increases in diastolic arterial pressu re and heart rate immediately after intubation; these were not seen 5 min after intubation. There were no cardiovascular responses to incisi on. There were no significant changes in the AER after intubation or i ncision.