The effects of remifentanil on attenuating responses to tracheal extubation after pediatric adenotonsillectomy

Objective To observe the effects of remifentanil on attenuating responses to tracheal extubation and the characteristics of postoperative recovery after pediatric adenotonsillectomy.Methods 40 ASA physical status 1 patient,scheduled for elective pediatric adenotonsillectomy were randomly allocated to remifentanil group(group R) or control group(group C) with 20 cases each.Anesthesia was induced with fentanyl(2μg/kg),atropine(0.01mg/kg),propofol(2～3mg/kg),dexamethasone(0.1mg/kg) and vecuronium(0.1mg/kg).The anesthesia was continued with a continuous infusion of remifentanil 0.2～0.25μg·kg(-1)·min(-1) and propofol 4～6mg·kg(-1)·h(-1).At the end of surgery,a small-dose remifentanil was infused in group R or saline in group C and tracheal extubation was performed when standard criteria were achieved.SBP,DBP and HR were recorded respectively at pre-operation,1min pre-extubation,at extubation and 1,5min after extubation.The duration and the characteristics of postoperative recovery were also investigated.Results After extubation,the cardiovascular reactions were stable in group R.Comparing with R group,SBP,DBP,HR in group C significantly increased at extubation,1min pre-extubation and 1min after extubation.In group R the recovering time of spontaneous breathing,opening the eyes and extubation was not longer significantly compared with that in group C(P0.05).Conclusion The hypertension and tachycardia occurring during tracheal extubation can be attenuated by a small-dose remifentanil and the occurrence of bucking and restlessness is low.