British Journal of Anaesthesia, Vol 82, Issue 2 283-285, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
R. O'Hare, D. McAtamney, R. K. Mirakhur, D. Hughes and U. Carabine
The effect of three bolus doses of remifentanil on the pressor response to
laryngoscopy and tracheal intubation during rapid sequence induction of
anaesthesia was assessed in a randomized, double-blind, placebo- controlled
study in four groups of 20 patients each. After preoxygenation, anaesthesia
was induced with thiopental 5-7 mg kg-1 followed immediately by saline
(placebo) or remifentanil 0.5, 1.0 or 1.25 micrograms kg-1 given as a bolus
over 30 s. Cricoid pressure was applied just after loss of consciousness.
Succinylcholine 1 mg kg-1 was given for neuromuscular block. Laryngoscopy
and tracheal intubation were performed 1 min later. Arterial pressure and
heart rate were recorded at intervals until 5 min after intubation.
Remifentanil 0.5 microgram kg-1 was ineffective in controlling the increase
in heart rate and arterial pressure after intubation but the 1.0 and 1.25
micrograms kg-1 doses were effective in controlling the response. The use
of the 1.25 micrograms kg-1 dose was however, associated with a decrease in
systolic arterial pressure to less than 90 mm Hg in seven of 20 patients.
SHORT COMMUNICATIONS
Bolus dose remifentanil for control of haemodynamic response to tracheal intubation during rapid sequence induction of anaesthesia
Department of Anaesthetics, The Queen's University of Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, UK; Department of Clinical Anaesthesia, Royal Hospitals Trust, Belfast BT12 6BA, UK
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