title: Low-dose remifentanil to modify hemodynamic responses to tracheal intubation: comparison in normotensive and untreated/treated hypertensive Korean patients.
abstract: BACKGROUND
  Remifentanil has been shown to be effective at treating potentially adverse hemodynamic responses to tracheal intubation even at low doses (< 1 µg/kg/min), which needs to be evaluated in patients with diverse cardiovascular conditions.
  
  
  METHODS
  A low-dose regimen of remifentanil (continuous infusion of 0.1 µg/kg/min, preceded by 0.5 µg/kg bolus) was given before induction with bolus propofol and rocuronium, and heart rate as well as systolic, diastolic, and mean arterial pressures were measured at 1 min intervals from before induction to 5 min after tracheal intubation in normotensive patients, untreated hypertensive patients, and patients with known hypertension.
  
  
  RESULTS
  The low-dose regimen of remifentanil resulted in parallel hemodynamic responses in all three groups, and was effective at limiting hemodynamic responses to tracheal intubation without excessive cardiovascular depression. Hemodynamic responses in our study showed a similar pattern to that reported in previous investigations, except for elevations in heart rate and arterial pressures over the baseline values immediately after intubation.
  
  
  CONCLUSIONS
  We suggest that the low-dose regimen of remifentanil in our study could be routinely used to modify hemodynamic responses to tracheal intubation in patients with diverse hemodynamic characteristics. However, the development of supplementary regimens is still needed to control the brief, but exaggerated responses to tracheal intubation, especially in untreated hypertensive patients.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Yon-Hee
authors.initials: YH
authors.lastname: Shim
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Yoo
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Nam
authors.forename: Jong Wha
authors.initials: JW
authors.lastname: Lee