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Dose of remifentanil for minimizing the cardiovascular changes to tracheal intubation in pediatric patients

Sang-Ho Yoon1, Kyung-Han Kim, Suk-Hwan Seo

  • 1Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea.

Korean Journal of Anesthesiology
|September 30, 2010
PubMed

Insights

A 2.0 ug/kg dose of remifentanil effectively attenuated cardiovascular changes during anesthetic induction in pediatric patients. This dosage significantly reduced increases in systolic arterial pressure and heart rate following tracheal intubation compared to lower doses.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Cardiovascular changes during anesthetic induction are a concern in pediatric patients.
  • Remifentanil is an ultra-short-acting opioid used in anesthesia.

Purpose of the Study:

  • To investigate the optimal dosage of remifentanil for attenuating cardiovascular responses to tracheal intubation in pediatric anesthesia.

Main Methods:

  • A randomized study involving 90 pediatric patients (ASA 1, aged 4-15 years) received varying doses of remifentanil (1.0, 1.5, or 2.0 ug/kg) after midazolam, glycopyrrolate, and thiopental.
  • Tracheal intubation was performed 90 seconds after remifentanil administration.
  • Systolic arterial pressure (SAP), mean arterial pressure (MAP), and heart rate (HR) were measured at baseline and at intervals after intubation.

Main Results:

  • All groups showed increased SAP and HR immediately after intubation compared to baseline.
  • The 2.0 ug/kg remifentanil group (R 2) demonstrated significantly smaller percentage increases in SAP (10%) and HR (22%) compared to the 1.0 ug/kg (30% SAP, 30% HR) and 1.5 ug/kg (19% SAP, 24% HR) groups.
  • The R 2 group showed statistically significant attenuation of cardiovascular responses compared to the other groups.

Conclusions:

  • A bolus dose of 2.0 ug/kg remifentanil is effective in attenuating cardiovascular responses to tracheal intubation in pediatric anesthesia.
  • This dosage provides superior cardiovascular stability during anesthetic induction in children.
  • Remifentanil at 2.0 ug/kg represents a valuable option for managing hemodynamic stress in pediatric intubation.
Abstract

Keywords:
Cardiovascular changesChildrenRemifentanilTracheal intubation

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