title: Assessment of tracheal intubation in children after induction with propofol and different doses of remifentanil.
abstract: Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 micro g.kg-1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg-1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 micro g.kg-1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 micro g.kg-1 were better than in those given remifentanil 1.0 micro g.kg-1 (p < 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 micro g.kg-1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 micro g.kg-1 and in the control group (p < 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 micro g.kg-1 (p < 0.001). In conclusion, remifentanil 2 micro g.kg-1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.
authors.affiliation: Department of Anaesthesia, St Helier Hospital, Epsom and St Helier NHS Trust, Wrythe Lane, Carshalton, Surrey UK. jmblair@doctors.org.uk
authors.forename: J M
authors.initials: JM
authors.lastname: Blair
authors.forename: D A
authors.initials: DA
authors.lastname: Hill
authors.forename: C M
authors.initials: CM
authors.lastname: Wilson
authors.forename: J P H
authors.initials: JP
authors.lastname: Fee
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol; D000077208:Remifentanil; D012119:Respiration / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D009638:Norepinephrine; D015742:Propofol; D004837:Epinephrine