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Minerva Anestesiologica 2004 March;70(3):109-15

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Peri-intubation cardiovascular response during low dose remifentanil or sufentanil administration in association with propofol TCI A double blind comparison

Iannuzzi E., Iannuzzi M., Cirillo V., Viola G., Parisi R., Cerulli A., Chiefari M.

Department of Anaesthesiological Surgical and Emergency Sciences Second University of Naples, Naples, Italy


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Aim. The aim of ­this ­study was to com­pare the ­effects on car­di­o­vas­cu­lar mod­ifi­ca­tions ­induced by tra­cheal intu­ba­tion ­when low ­dose infu­sion of remi­fen­ta­nil or sufen­ta­nil are ­used in asso­ci­a­tion ­with pro­pof­ol tar­get con­trolled infu­sion.
Meth­ods. Six­ty nor­mo­ten­sive, ASA I-II-III, Mal­lam­pa­ti ­Score <3 under­go­ing gen­er­al anaesthe­sia for ­major elec­tive abdom­i­nal sur­gery, ­received i.m. mid­az­o­lam (0.05 mg/kg) and atro­pine (0.01 mg/kg) 30 min ­before induc­tion. ­They ­were ran­dom­ly divid­ed in a dou­ble-­blind fash­ion ­into two ­groups receiv­ing for induc­tion respec­tive­ly tar­get con­trolled infu­sion of pro­pof­ol (­site-­effect 3.0 µg/ml) and sufen­ta­nil (0.01 µg/kg/min) or remi­fen­ta­nil (0.1 µg/kg/ min) infu­sion. Roc­u­ro­ni­um (0.6 mg/kg) was admin­is­tered. Fol­low­ing intu­ba­tion, the ­lungs ­were mechan­i­cal­ly ven­ti­lat­ed ­with an oxy­gen/air mix­ture.
­Results. Bispec­tral ­index ­score and hae­mod­y­nam­ic var­i­ables ­were record­ed at base­line, ­after induc­tion, dur­ing intu­ba­tion and 1-3-5 min ­after the tra­chea was intu­bat­ed. No dif­fer­enc­es in sys­tol­ic and dia­stol­ic arte­ri­al pres­sure ­were ­observed in the sufen­ta­nil ­group, ­while the remi­fen­ta­nil ­group ­showed tran­sient sys­tol­ic and dia­stol­ic vari­a­tions ­after intu­bat­ing manoeuv­ers. The ­heart ­rate and bispec­tral ­index ­score ­were not affect­ed in ­either ­group.
Con­clu­sion. In ­healthy nor­mo­ten­sive ­patients the use of a ­small ­dose of ­either remi­fen­ta­nil or sufen­ta­nil ­after stan­dard mid­az­o­lam pre­med­i­ca­tion, ­proved to be an effec­tive strat­e­gy to ­blunt the car­di­o­vas­cu­lar ­response to intu­ba­tion.

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