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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2000 Novembre;66(11):793-7


language: Italian

The effects of remifentanil on hemodynamic response to intubation. A comparative study with fentanyl

Cafiero T., Mastronardi P., Burrelli R., Santoro R.

*Università degli Studi «Federico II» - Napoli ASL CE/2 - Sessa Aurunca Ospedale «San Rocco» Servizio di Anestesia e Rianimazione


Back­ground. The aim of ­this ­study was to eval­u­ate the ­effects of remi­fen­ta­nil in com­par­i­son ­with ­those of fen­ta­nyl on the hemo­dy­nam­ic ­response to orot­ra­cheal intu­ba­tion.
Meth­ods. Experi­men­tal ­design: pros­pec­tive com­par­a­tive and ran­dom­ized ­study. Set­ting: oper­at­ing ­room in a neu­ro­sur­gery depart­ment at Uni­ver­sity. ­Patients: 50 ­patients, ASA I or II ­with age rang­ing ­from 32 to 64 ­years ­were divid­ed in two ­groups ran­dom­ly. Inter­ven­tions: 25 ­patients ­received fen­ta­nyl as sin­gle ­bolus ­dose of 2.0 µg/kg and atro­pine 0.01 mg/kg i.v. as pre­med­i­ca­tion ­while the remain­ders ­received atro­pine 0.01 mg/kg i.v. and remi­fen­ta­nil 0.2 µg/kg/min as infu­sion. All ­patients ­were ­induced ­with pro­pof­ol 2.0 mg/kg and cisat­ra­cu­ri­um 0.15 mg/kg for mus­cle relax­a­tion and ­were intu­bat­ed 4 min ­after induc­tion of anes­the­sia. Meas­ure­ments: ­Heart ­rate, SAP, DAP, MAP and RPP ­were record­ed at dif­fer­ent ­times: base­line, induc­tion, intu­ba­tion, 1, 2, 3 and 4 min ­after intu­ba­tion; ECG and pul­sox­im­e­try ­were mon­i­tored con­tin­u­ous­ly. Sta­tis­ti­cal anal­y­sis was car­ried out ­using ANO­VA for repeat­ed meas­ures and Bon­fer­ro­ni t-test a val­ue of p<0.05 was con­sid­ered to be sig­nif­i­cant.
­Results. Sig­nif­i­cant increas­es in PAS ­were record­ed, at intu­ba­tion and at 1 min ­after in ­patients treat­ed ­with fen­ta­nyl; in the remi­fen­ta­nil ­group sig­nif­i­cant decreas­es in SAP at induc­tion and at 4 min ­after intu­ba­tion ­were record­ed. HR ­increased sig­nif­i­cant­ly at intu­ba­tion and at 1, 2 and 3 min ­after in the fen­ta­nyl ­group. RPP ­showed a sig­nif­i­cant decrease at induc­tion in the remi­fen­ta­nil ­group and sig­nif­i­cant increas­es at intu­ba­tion and at 1, 2 and 3 min ­after in ­patients treat­ed ­with fen­ta­nyl.
Con­clu­sion. In con­clu­sion remi­fen­ta­nil was ­found to prop­er­ly con­trol the hemo­dy­nam­ic ­response to intu­ba­tion in com­par­i­son ­with fen­ta­nyl.

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