Korean J Anesthesiol.  2012 Feb;62(2):135-141. 10.4097/kjae.2012.62.2.135.

Low-dose remifentanil to modify hemodynamic responses to tracheal intubation: comparison in normotensive and untreated/treated hypertensive Korean patients

• Park SJ
• Shim YH
• Yoo JH
• Nam SH
• Lee JW

• KMID: 2236292
• DOI: http://doi.org/10.4097/kjae.2012.62.2.135

Abstract

BACKGROUND
Remifentanil has been shown to be effective at treating potentially adverse hemodynamic responses to tracheal intubation even at low doses (< 1 microg/kg/min), which needs to be evaluated in patients with diverse cardiovascular conditions.
METHODS
A low-dose regimen of remifentanil (continuous infusion of 0.1 microg/kg/min, preceded by 0.5 microg/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 1 min intervals from before induction to 5 min 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 our 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.
CONCLUSIONS
We suggest that the low-dose regimen of remifentanil in our 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.

Keyword

Hemodynamics; Hypertension; Remifentanil; Tracheal intubation

MeSH Terms

Androstanols
Arterial Pressure
Depression
Heart Rate
Hemodynamics
Humans
Hypertension
Intubation
Piperidines
Propofol
Androstanols
Piperidines
Propofol