Abstract:
BACKGROUND AND OBJECTIVES:High doses of opioids decrease the hemodynamic response to tracheal intubation. However, the slow recovery profile of traditional opioids may limit the use of high doses. Remifentanil has a fast time of onset and is short acting, which differentiates it from the other drugs in this class. The primary objective of this study was to verify the hypothesis that there is no need to initiate the administration of remifentanil before the induction with propofol. METHODS:Thirty patients, divided in two groups, who received total intravenous anesthesia, were evaluated. In Group 1, the infusion of remifentanil (0.3 microg.kg-1.min-1) was initiated two minutes before induction, and in Group 2, at the same time of the induction. Systolic, diastolic, and mean arterial blood pressure (SBP, DBP, MAP), heart rate (HR), concentration of propofol (CEF-prop) and remifentanil (CEF-remi) in the effector area in three moments: baseline (M0), after losing verbal contact (M1), and after tracheal intubation (M2) were evaluated. RESULTS:There were significant reductions in blood pressure in both groups at M1 and M2. CEF-remi was greater in Group 1, at M1, and greater in Group 2, at M2 (p < 0.05). There was a significant statistical correlation between the vascular overload index (VOI) and the variation of the systolic pressure after the loss of verbal contact in Group 1 (r = -0.80; p < 0.01) and in Group 2 after tracheal intubation (r = -0.60; p < 0.01). CONCLUSIONS:Remifentanil administered two minutes before induction with propofol did not offer additional cardiovascular protection to tracheal intubation. This suggests that it is not necessary to start the infusion of remifentanil two minutes before anesthetic induction.
journal_name
Rev Bras Anestesioljournal_title
Revista brasileira de anestesiologiaauthors
Nora FS,Klipel R,Ayala G,Oliveira Filho GRdoi
10.1590/s0034-70942007000300003subject
Has Abstractpub_date
2007-06-01 00:00:00pages
247-60issue
3eissn
0034-7094issn
1806-907Xpii
S0034-70942007000300003journal_volume
57pub_type
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,随机对照试验
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更新日期:2012-01-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,评审
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