Korean J Anesthesiol.  2008 Jan;54(1):18-24. 10.4097/kjae.2008.54.1.18.

Comparison of Effects of Fentanyl, Alfentanil and Remifentanil on the Cardiovasuclar Response to Endotracheal Intubation during the Induction of General Anesthesia

• Hwang JH
• Kim YH
• Lee JH
• Jung YS
• Go YK
• Yoon MJ
• Yoon SH

• KMID: 2236566
• DOI: http://doi.org/10.4097/kjae.2008.54.1.18

Abstract

BACKGROUND: Opioids are the most widely used drugs to minimize the increase of blood pressure and heart rate in endotracheal intubation during the induction of anesthesia. The purpose of this study was to compare the effects of fentanyl, alfentanil, and remifentanil on the cardiovascular response to laryngoscopic endotracheal intubation.
METHODS
Eighty ASA I-II patients were randomly allocated to four groups. The patients received 10 ml intravenous saline (control group), 3microgram/kg fentanyl (fentanyl group), 10microgram/kg alfentanil (alfentanil group) or 0.5microgram/kg remifentanil followed by an infusion of 0.1microgram/kg/min remifentanil (remifentanil group). Anesthesia was induced with propofol and rocuronium and maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The noninvasive blood pressure and heart rate were recorded before induction (baseline), after induction, before intubation, and at 1 min intervals until 5 min after endotracheal intubation.
RESULTS
Arterial pressure and heart rate after endotracheal intubation were lower in the fentanyl, alfentanil, and remifentanil groups than in the control group (P < 0.05). There were no significant differences for arterial pressure or heart rate in the fentanyl, alfentanil, and remifentanil groups at any time. There were no significant differences for the incidence of hypotension and bradycardia among the four groups.
CONCLUSIONS
Administration of 3microgram/kg fentanyl, 10microgram/kg alfentanil and 0.5microgram/kg remifentanil followed by an infusion of 0.1microgram/kg /min remifentanil have a similar effect in the suppression of the cardiovascular response to laryngoscopic endotracheal intubation during the induction of general anesthesia.

Keyword

alfentanil; cardiovascular; fentanyl; intubation; remifentanil

MeSH Terms

Alfentanil
Analgesics, Opioid
Androstanols
Anesthesia
Anesthesia, General
Arterial Pressure
Blood Pressure
Bradycardia
Fentanyl
Heart Rate
Humans
Hypotension
Incidence
Intubation
Intubation, Intratracheal
Methyl Ethers
Nitrous Oxide
Oxygen
Piperidines
Propofol
Alfentanil
Analgesics, Opioid
Androstanols
Fentanyl
Methyl Ethers
Nitrous Oxide
Oxygen
Piperidines
Propofol