Effect of bolus dose of remifentanil on haemodynamic response to tracheal intubation

Citation
K. Barclay et Mt. Kluger, Effect of bolus dose of remifentanil on haemodynamic response to tracheal intubation, ANAESTH I C, 28(4), 2000, pp. 403-407
Citations number
12
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
ANAESTHESIA AND INTENSIVE CARE
ISSN journal
0310057X → ACNP
Volume
28
Issue
4
Year of publication
2000
Pages
403 - 407
Database
ISI
SICI code
0310-057X(200008)28:4<403:EOBDOR>2.0.ZU;2-0
Abstract
A randomized placebo-controlled double-blinded study was conducted in 40 AS A 1 and 2 patients to determine the dose response of remifentanil in attenu ating the haemodynamic response to tracheal intubation. Patients were alloc ated to one of four groups: placebo, remifentanil 1 mu g.kg(-1), remifentan il 2 mu g.kg(-1) and remifentanil 4 mu g.kg(-1). A propofol target-controll ed infusion was started at 4 mu g.ml(-1) and incrementally titrated to loss of verbal contact, Muscle relaxation was provided by cisatracurium. The st udy drug was given three minutes later over 30 seconds, and 90 seconds late r the patient's trachea Il,as intubated under direct laryngoscopy. Baseline noninvasive blood pressure an heart rate recordings were made prior to sta rting target-controlled infusion, then at one-minute intervals after loss o f verbal contact for the duration of the study. Demographic data and target -controlled infusion rate at intubation was similar for the groups. Followi ng intubation, heart rate increased by 15% in the placebo group, 10% iii I mu g.kg(-1) group, with no changes ill 2 mu g.kg(-1) and 4 mu g.kg(-1) grou ps. Systolic blood pressure following intubation ina eased by 30% in the pl acebo group, 10% in the I mu g.kg(-1) group and remained unchanged in the 2 mu g.kg(-1) and 4 mu g.kg(-1) groups. Remifentanil I mu g.kg(-1) attenuate d the rise in heart rate and systolic blood pressure. Remifentanil 2 mu g.k g(-1) blocked the haemodynamic response completely: no further benefit was shown from increasing the dose to 4 mu g.kg(-1).