ORIGINAL ARTICLES  ANESTHESIA Free access

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

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.