British Journal of Anaesthesia, Vol 80, Issue 4 467-469, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. P. Thompson, A. P. Hall, J. Russell, B. Cagney and D. J. Rowbotham
We have examined the effect of remifentanil on the haemodynamic response to
orotracheal intubation in a randomized, double-blind study. We studied 40
patients allocated to one of four groups of 10 each, to receive the
following immediately before induction of anaesthesia: remifentanil 1
microgram kg-1 bolus over 30 s, followed by an infusion of 0.5 microgram
kg-1 min-1; saline placebo only; glycopyrrolate 200 micrograms and
remifentanil 1 microgram kg-1 bolus over 30 s, followed by an infusion of
0.5 microgram kg-1 min-1; or glycopyrrolate 200 micrograms only.
Anaesthesia was induced with propofol, vecuronium and 1% isoflurane with
66% nitrous oxide in oxygen. The trachea was intubated under direct
laryngoscopy 3 min after induction of anaesthesia. Arterial pressure and
heart rate were measured non- invasively, immediately before induction of
anaesthesia and then at 1- min intervals. Remifentanil was found to
effectively attenuate the pressor response to intubation (P < 0.05 for
the increase in mean arterial pressure; P < 0.01 for the increase in
heart rate). In the absence of a concurrent vagolytic agent, remifentanil
was associated with bradycardia or hypotension, or both, in five of 10
patients, compared with one patient who received remifentanil and
glycopyrrolate.
CLINICAL INVESTIGATIONS
Effect of remifentanil on the haemodynamic response to orotracheal intubation
University Department of Anaesthesia, Leicester Royal Infirmary, Leicester LE1 5WW
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