Effect of a remifentanil bolus dose on the cardiovascular response to emergence from anaesthesia and tracheal extubation

We have examined the effect of remifentanil on the haemodynamic response to emergence from anaesthesia and tracheal extubation in 40 ASA I-II female p atients undergoing diagnostic laparoscopy, in a randomized, double-blind st udy. All patients received a standard general anaesthetic comprising propof ol, vecuronium and 1% isoflurane with 66% nitrous oxide in oxygen. At the e nd of surgery, a bolus dose of remifentanil 1 mu g kg(-1) (n = 20) or salin e placebo (n = 20) was given and tracheal extubation was performed when sta ndard criteria were achieved. Arterial pressure and heart rate were recorde d non-invasively at 1-min intervals from the end of surgery. Remifentanil a ttenuated the increase in both mean arterial pressure (P < 0.001) and heart rate (P < 0.05) at extubation. Mean time to extubation was 7.2 (SEM 0.6) m in and 4.0 (0.5) min in the remifentanil and saline groups, respectively (P < 0.001). There was no difference in the incidence of coughing at extubati on, time to recovery from anaesthesia or time to fitness for discharge from the recovery room.