Effects of remifentanil on cardiovascular response to tracheal intubation in the elderly

Objective To investigate the effects of different doses of remifentanil on the cardiovascular responses to tracheal intubation in the elderly.Methods Sixty gerontic surgical patients were randomized into six groups with 10 cases each.The patients were induced with propofol at a rate of 33 mg/min up to loss of conciousness,which was followed by infusion of remifentanil 0.15(group Ⅰ),0.20(group Ⅱ) or 0.25 μg·kg-1·min-1(group Ⅲ) for 6 min and 0.15(group Ⅳ),0.20(group Ⅴ) or 0.25 μg·kg-1·min-1(group Ⅵ) for 8 min.Rocuronium 0.6 mg/kg was injected to facilitate tracheal intubation.The blood pressure(BP) and heart rate(HR) were recorded before intubation(T0),at 1 min before tracheal intubation(T1),1 min(T2),2 min(T3),3 min(T4),4 min(T5),5 min(T6) after tracheal intubation.Results Compared to T0,BP and HR of six groups decreased markedly at T1(P 0.05 or P0.01).HR of groups of Ⅲ,Ⅴ and Ⅵ was obviously lower at T2 and T4 than that at T0(P0.05 or P0.01).SBP and DBP in groups of Ⅰ and Ⅱ at T2-T3 and SBP in group Ⅳ at T2-T4 were obviously higher than those at T1(P0.05 or P0.01).Compared to T1,HR of groups of Ⅰ,Ⅳ and Ⅴ at T2-T6 increased significantly,so did that of group Ⅱ at T2-T3,group Ⅲ at T3-T6,and group Ⅵ at T3-T5(P0.05 or P0.01).Conclusion Remifentanil infused at a rate of 0.20 μg·kg-1·min-1 for 6 min or more may effectively attenuate the cardiovascular response to tracheal intubation in the elderly.