title: Effect of a remifentanil bolus dose on the cardiovascular response to emergence from anaesthesia and tracheal extubation.
abstract: We have examined the effect of remifentanil on the haemodynamic response to emergence from anaesthesia and tracheal extubation in 40 ASA I-II female patients undergoing diagnostic laparoscopy, in a randomized, double-blind study. All patients received a standard general anaesthetic comprising propofol, vecuronium and 1% isoflurane with 66% nitrous oxide in oxygen. At the end of surgery, a bolus dose of remifentanil 1 microgram kg-1 (n = 20) or saline placebo (n = 20) was given and tracheal extubation was performed when standard criteria were achieved. Arterial pressure and heart rate were recorded non-invasively at 1-min intervals from the end of surgery. Remifentanil attenuated the increase in both mean arterial pressure (P < 0.001) and heart rate (P < 0.05) at extubation. Mean time to extubation was 7.2 (SEM 0.6) min and 4.0 (0.5) min in the remifentanil and saline groups, respectively (P < 0.001). There was no difference in the incidence of coughing at extubation, time to recovery from anaesthesia or time to fitness for discharge from the recovery room.
authors.affiliation: University Department of Anaesthesia, Leicester Royal Infirmary, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Shajar
authors.forename: J P
authors.initials: JP
authors.lastname: Thompson
authors.forename: A P
authors.initials: AP
authors.lastname: Hall
authors.forename: N A
authors.initials: NA
authors.lastname: Leslie
authors.forename: A J
authors.initials: AJ
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D001794:Blood Pressure / Q000187:drug effects; D020878:Device Removal; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology*; D000077208:Remifentanil; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil