A Comparison of the Effects of Remifentanil and Alfentanil on Hemodynamic Responses to Endotracheal Intubation in Hypertensive Patients

Yoo, Eun Sook; Ahn, Eun Kyoung; Kang, Sang Hwa; Kim, Youn Suk

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Anesthetic Pharmacology

Anesthesia and Pain Medicine 2008;3(2):114-117.
Published online April 30, 2008.

A Comparison of the Effects of Remifentanil and Alfentanil on Hemodynamic Responses to Endotracheal Intubation in Hypertensive Patients

Eun Sook Yoo, Eun Kyoung Ahn, Sang Hwa Kang, Youn Suk Kim

Department of Anesthesiology and Pain Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. jerifer00@yahoo.co.kr

Abstract

BACKGROUND
Laryngoscopy and endotracheal intubation often provoke an undesirable increase in blood pressure and heart rate. This response may be exaggerated in patients with essential hypertension. We compared the effect of administration of remifentanil and alfentanil on the hemodynamic responses to endotracheal intubation in patients with essential hypertension. METHODS: Forty patients with essential hypertension were allocated into two groups. The remifentanil group received 0.5micro g/kg remifentanil followed by an infusion of 0.25microg/kg/min remifentanil. The alfentanil group received 10microg/kg alfentanil intravenously. Anesthesia was induced with thiopental and vecuronium, and was maintained with 2 vol% sevoflurane with 100% oxygen. Laryngoscopy and tracheal intubation were performed 3 min after vecuronium administration. Arterial blood pressure and heart rate were measured in patients after arrival at the operating room and before and after intubation. RESULTS: The systolic and mean blood pressure after intubation showed significantly higher values in the alfentanil group of patients than in the remifentanil group of patients. There was no significant difference in blood pressure measured at baseline and after intubation in the remifentanil group of patients, but blood pressure showed significantly higher values after intubation in the alfentanil group of patients. Heart rate showed significantly higher values after intubation than at baseline in each group of patients. CONCLUSIONS: These results show that the administration of 0.5micro g/kg remifentanil followed by an infusion of 0.25microg/kg/min remifentanil attenuated the pressor response to endotracheal intubation more significantly than the administration of 10microg/kg alfentanil in patients with essential hypertension.

Key Words: alfentanil, hypertension, intubation, remifentanil

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