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Anesth Pain Med > Volume 10(2); 2015 > Article
Anesthetic Pharmacology
Anesthesia and Pain Medicine 2015;10(2):104-109.
DOI: https://doi.org/10.17085/apm.2015.10.2.104    Published online April 30, 2015.
Optimal dose of remifentanil for the prevention of hemodynamic responses during induction of anesthesia with desflurane
Hyoseok Kang, Hye Jin Park, Seung Min Baek, Sun Oh Kim
Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea. anesthjin@eulji.ac.kr
Received: 23 December 2014   • Revised: 1 January 2015   • Accepted: 3 February 2015
Abstract
BACKGROUND
This study was designed to determine the optimal dose of remifentanil single bolus for the prevention of cardiovascular disturbance due to both a rapid increase in desflurane concentration and stimulation by intubation.
METHODS
One hundred three adult patients were enrolled in this prospective, double-blind, randomized study. Before anesthesia induction, all patients received normal saline (control) or one of the following 3 doses of remifentanil: 1.0 microg/kg of remifentanil (remifentanil 1.0), 1.5 microg/kg of remifentanil (remifentanil 1.5), and 2.0 microg/kg of remifentanil (remifentanil 2.0). After induction with propofol and rocuronium, 1.3 minimal alveolar concentration of desflurane with oxygen was administered via a face mask. Heart rate (HR) and mean blood pressure (MBP) were recorded before remifentanil administration, and 1, 2, and 3 min after inhalation of desflurane, as well as 0, 1, 2, and 3 min after intubation. The proportions of patients with hemodynamics that maintained within +/- 25% of preinduction values (MBP and HR proportion) were calculated.
RESULTS
MBP and HR were lower in the 3 remifentanil groups than in the control group throughout the study period. The MBP proportion was higher in remifentanil 1.0 group than in control group. The HR proportion was higher in the 3 remifentanil groups than in control group.
CONCLUSIONS
A single bolus injection of remifentanil (1.0-2.0 microg/kg) may be effective in alleviating adverse hemodynamic changes induced by both desflurane inhalation and tracheal intubation. Especially, administration of remifentanil 1.0 microg/kg maintained more stable blood pressure compared to the control group throughout the study period.
Key Words: Desflurane, Hypertension, Intubation, Remifentanil, Tachycardia


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