title: Administration of Remifentanil in Establishing a more Stable Post-anesthesia Cardiovascular Status in Neurosurgical Procedures.
abstract: BACKGROUND
  Emergence from general anesthesia and especially post-extubation phase are the stages associated with cardiovascular hyperdynamic status in which patients with increased intracranial pressure (ICP) could be affected by severe cardiac and or cerebral complications. Administering remifentanil could be helpful in maintaining the hemodynamic stability at the end of the surgery and recovery stages and reducing recovery phase length.
  
  
  METHODS
  In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving remifentanil and placebo as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation.
  
  
  RESULTS
  There was a significant difference between two groups regarding the changes of Mean Arterial Pressure after extubation and five minutes after extubation (P˂ 0.001).Remifentanil group compared with control group was of significant difference at all heart rate values after extubation (P< 0.001).
  
  
  CONCLUSIONS
  Remifentanil could be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length. However, administration of this medication should be performed cautiously.
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hamzeh
authors.initials: H
authors.lastname: Hosseinzadeh
authors.forename: Mahmood
authors.initials: M
authors.lastname: Eydi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ghaffarlou
authors.forename: Kamyar
authors.initials: K
authors.lastname: Ghabili
authors.forename: Samad Ej
authors.initials: SE
authors.lastname: Golzari
authors.forename: Amir Mohammad
authors.initials: AM
authors.lastname: Bazzazi
keywords: Cardiovascular Stability; Recovery; Remifentanil