Low-dose remifentanil to modify hemodynamic responses to tracheal intubation

Korean Journal of Anesthesiology, 02/27/2012

Park SJ et al. – The authors suggest that the low-dose regimen of remifentanil in the study could be routinely used to modify hemodynamic responses to tracheal intubation in patients with diverse hemodynamic characteristics. However, the development of supplementary regimens is still needed to control the brief, but exaggerated responses to tracheal intubation, especially in untreated hypertensive patients.

Methods

  • A low-dose regimen of remifentanil (continuous infusion of 0.1µg/kg/min, preceded by 0.5µg/kg bolus) was given before induction with bolus propofol and rocuronium, and heart rate as well as systolic, diastolic, and mean arterial pressures were measured at 1min intervals from before induction to 5min after tracheal intubation in normotensive patients, untreated hypertensive patients, and patients with known hypertension.

Results

  • The low-dose regimen of remifentanil resulted in parallel hemodynamic responses in all three groups, and was effective at limiting hemodynamic responses to tracheal intubation without excessive cardiovascular depression.
  • Hemodynamic responses in the study showed a similar pattern to that reported in previous investigations, except for elevations in heart rate and arterial pressures over the baseline values immediately after intubation.

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