title: Different remifentanil doses in rapid sequence anesthesia induction: BIS monitoring and intubation conditions.
abstract: OBJECTIVE
  The aim of this prospective, randomized, double blind trial was to investigate the effects of two different doses of remifentanil on bispectral index (BIS) values and intubation conditions in a simulated model of rapid sequence anesthesia induction (RSAI).
  
  
  METHODS
  54 ASA I-II adult patients undergoing elective surgery were randomly allocated to two groups. After preoxygenation for 3 minutes, induction and tracheal intubation was performed in a 300 head-up position. Group I (n=26) and Group II (n=28) received a 1 µg/kg or 0.5 µg/kg bolus of remifentanil, respectively, over 30 seconds. Propofol was the induction agent. 1 mg/kg of rocuronium was used in all patients. Patients were intubated 60 s after administration of the muscle relaxant. Hemodynamic data and BIS scores were obtained before induction (baseline), after induction, at intubation and at 1, 3, 5 and 10 minutes following intubation. Intubation conditions were scored with a standard scoring system.
  
  
  RESULTS
  The hemodynamic variables at all the measurement intervals and the area under the hemodynamic variable-time curves were similar among the groups. There was no difference among the groups for BIS measurements. Moreover, the mean area under the BIS-time curve for Group I (300±45cm2) was comparable to Group II (315±49cm2) (p=0.432). The mean total intubation condition score (maximum 14 points) in Group I (12.6±1.67) was higher than Group II (10.3±4.79) (p=0.030).
  
  
  CONCLUSIONS
  1 µg/kg of remifentanil compared to 0.5 µg/kg of remifentanil provides similar hemodynamic profiles and BIS scores, but 1 µg/kg of remifentanil was associated with superior endotracheal intubation conditions. According to this study design and medications used, a relation between BIS scores and intubation conditions couldn't be demonstrated.
authors.affiliation: Ankara University School of Medicine, Department of Anaesthesiology & ICM, Ankara, Turkey.
authors.forename: Zekeriyya
authors.initials: Z
authors.lastname: Alanoğlu
authors.forename: Sinem
authors.initials: S
authors.lastname: Tolu
authors.forename: Saban
authors.initials: S
authors.lastname: Yalçın
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Batislam
authors.forename: Oya
authors.initials: O
authors.lastname: Özatamer
authors.forename: Filiz
authors.initials: F
authors.lastname: Tüzüner
mesh_terms: D000328:Adult; D000758:Anesthesia; D019540:Area Under Curve; D062186:Arterial Pressure / Q000187:drug effects; D056805:Consciousness Monitors; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D010880:Piperidines / Q000008:administration & dosage* / Q000494:pharmacology*; D000077208:Remifentanil; D013599:Systole / Q000187:drug effects
chemical_list: D010880:Piperidines; D000077208:Remifentanil