comparison of hemodynamic responses associated with tracheal intubation under various induction doses of remifentanil and propofol比较与气管插管相关的血流动力学反应在不同诱导剂量的remifentanil和异丙酚.pdfVIP

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comparison of hemodynamic responses associated with tracheal intubation under various induction doses of remifentanil and propofol比较与气管插管相关的血流动力学反应在不同诱导剂量的remifentanil和异丙酚.pdf

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comparison of hemodynamic responses associated with tracheal intubation under various induction doses of remifentanil and propofol比较与气管插管相关的血流动力学反应在不同诱导剂量的remifentanil和异丙酚

Open Journal of Anesthesiology, 2012, 2, 154-160 /10.4236/ojanes.2012.24035 Published Online September 2012 (http://www.SciRP.org/journal/ojanes) Comparison of Hemodynamic Responses Associated with Tracheal Intubation under Various Induction Doses of Remifentanil and Propofol * Toru Goyagi , Masashi Yoshimoto Department of Anesthesia and Intensive Care Medicine, Graduate School of Medicine, Akita University, Akita, Japan. * Email: tgoyagi@doc.med.akita-u.ac.jp Received June 23rd, 2012; revised July 25th, 2012; accepted August 16th, 2012 ABSTRACT Background: The optimal dose of propofol and remifentanil induction to minimize the cardiovascular response associ- ated with tracheal intubation may exist. We investigated the cardiovascular response associated with tracheal intubation when various continuous induction doses of remifentanil in combination with propofol were used. Methods: Seventy- five patients were randomly allocated into 1 of 3 groups: the R-0.4 P-1 group (remifentanil 0.4 μg/kg/min and propofol 1 mg/kg); the R-0.5 P-1 group (remifentanil 0.5 μg/kg/min and propofol 1 mg/kg); and the R-0.4 P-2 group (remifen- tanil 0.4 μg/kg/min and propofol 2 mg/kg). One minute after remifentanil infusion commenced, a bolus of propofol was injected. Rocuronium 1 mg/kg was administered 1 min after propofol injection following loss of consciousness. Con- trolled ventilation was then performed for 2 min, and the trachea was intubated 4 min after the start of the remifentanil infusion. The infusion rate of remifentanil was decreased to 0.1 μg/kg/min after intubation. Blood pressure (BP) and heart rate (HR) were measured during this period until 5 min after tracheal intubation. Results: The changes in BP re- sponse due to tracheal intubation in the R-0.4 P-1 group were greater than those in the other 2 groups, whereas the HR responses to tracheal intubation were similar among the 3 groups. Conclusion: The combination of rem