[The effects of remifentanil on hemodynamic response to  intubation. A comparative study with fentanyl]  .
BACKGROUND
The aim of this study was to evaluate the effects of remifentanil in comparison with those of fentanyl on the hemodynamic response to orotracheal intubation.


METHODS



METHODS
prospective comparative and randomized study.


METHODS
operating room in a neurosurgery department at University.


METHODS
50 patients, ASA I or II with age ranging from 32 to 64 years were divided in two groups randomly.


METHODS
25 patients received fentanyl as single bolus dose of 2.0 micrograms/kg and atropine 0.01 mg/kg i.v. as premedication while the remainders received atropine 0.01 mg/kg i.v. and remifentanil 0.2 microgram/kg/min as infusion. All patients were induced with propofol 2.0 mg/kg and cisatracurium 0.15 mg/kg for muscle relaxation and were intubated 4 min after induction of anesthesia.


METHODS
Heart rate, SAP, DAP, MAP and RPP were recorded at different times: baseline, induction, intubation, 1, 2, 3 and 4 min after intubation; ECG and pulsoximetry were monitored continuously. Statistical analysis was carried out using ANOVA for repeated measures and Bonferroni t-test a value of p < 0.05 was considered to be significant.


RESULTS
Significant increases in PAS were recorded, at intubation and at 1 min after in patients treated with fentanyl; in the remifentanil group significant decreases in SAP at induction and at 4 min after intubation were recorded. HR increased significantly at intubation and at 1, 2 and 3 min after in the fentanyl group. RPP showed a significant decrease at induction in the remifentanil group and significant increases at intubation and at 1, 2 and 3 min after in patients treated with fentanyl.


CONCLUSIONS
In conclusion remifentanil was found to properly control the hemodynamic response to intubation in comparison with fentanyl.
Cafiero
T
T
Servizio di Anestesia e Rianimazione, Ospedale San Rocco, Università degli Studi Federico II Napoli. tulliocafiero@libero.it
Mastronardi
P
P
Burrelli
R
R
Santoro
R
R
D000328:Adult; D018686:Anesthetics, Intravenous; D005260:Female; D005283:Fentanyl; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010880:Piperidines; D011446:Prospective Studies; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl
Gli effetti del remifentanil sulla risposta emodinamica all'intubazione. Studio comparativo con il fentanyl.