Remifentanil vs. lignocaine for attenuating the haemodynamic response during rapid sequence induction using propofol: double-blind randomised clinical trial

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Kim, J. T.; Shim, J. K.; Kim, S. H.; Ryu, H. G.; Yoon, S. Z.; Jeon, Y. S.; Bahk, J. H.; Kim, C. S.
Issue Date
Australian Society of Anaesthetists
Anaesth Intensive Care. 2007 Feb;35(1):20-3.
AdultAnalysis of VarianceAnesthesia, General/methodsAnesthetics, Combined/*pharmacologyAnesthetics, IntravenousBlood Pressure/*drug effectsDouble-Blind MethodHeart Rate/*drug effectsHumans*Intubation, IntratrachealLaryngoscopyLidocaine/*pharmacologyMalePiperidines/*pharmacologyPropofol
This study was conducted to determine whether lignocaine or remifentanil effectively attenuate the response to endotracheal intubation during rapid sequence induction. Forty-eight patients were randomly divided into three groups: Group NS (n = 16) received normal saline 0.1 ml/kg, Group L (n = 16) received lignocaine 1.5 mg/kg, and Group R (n = 16) received remifentanil 1 microg/kg. Anaesthesia was induced with propofol 2 mg/kg after glycopyrrolate 0.2 mg IV. Each study drug was given intravenously over 30 seconds after loss of consciousness. Cricoid pressure was applied until intubation. Succinylcholine 1.0 mg/kg was administered to facilitate tracheal intubation. After intubation, the patient's lungs were ventilated with sevoflurane 1% and nitrous oxide 50% in oxygen. Mean arterial pressure and heart rate were recorded before induction, at loss of consciousness, immediately before laryngoscopy and every minute after intubation for 10 minutes. Mean arterial pressure fell following propofol in all groups. The maximum increase in mean arterial pressure in Group NS and Group L were 46% and 38% respectively above the baseline value one minute after intubation, whereas the mean arterial pressure in Group R increased only back to the baseline value. Heart rate in Group NS and Group L were increased by 27% and 33% above baseline value respectively one minute after intubation, while that in Group R was increased only to the baseline value. The results indicate that remifentanil 1 microg/kg, but not lignocaine 1.5 mg/kg, effectively attenuates the haemodynamic response to endotracheal intubation during rapid sequence induction using propofol.
0310-057X (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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