Different doses of remifentanil combined with sevoflurane used to tracheal intubation in children without relaxants

Objective To study the dose-effect of remifentanil for tracheal intubation in children anesthetized with 2.5% sevoflurane inhalation without relalants. Methods Forty-five pediatric patients were assigned into three groups with different doses of remifentanil: group R1(remifentanil 2.0μg·kg-1),group R2(remifentanil 2.5μg/kg),group R3(remifentanil 3.0μg/kg).Anesthsia was induced by sevoflurane inhalation at 8vol%.When the patients lost consciousness,maintained by 2.5% sevoflurane inhalation for 15min,anesthesia were followed by remifentanil 2.0,2.5,3.0μg/kg,respectively. MAP and HR were recorded before induction,before intubation,and at 1 and 3 min after intubation.Intubation conditions was evaluated. Results The satisfactory degree of intubation conditions in group R1 was significantly lower compared to that in group R2 and R3(χ2=6.71,P0.05),but there was no siginifacant difference between group R2 and group R3 (χ2=0.24,P0.05).There was a significant reduction in MAP and HR before intubation compared to those before induction in all groups(F= 7.56,6.35,P0.05).Tracheal intubation was associated with an increase in MAP and HR in group R1(F =13.34,11.75,P0.05),and there was more increase in group R1 than that in group R2 and R3(F=8.59,7.81,P0.05).There was no significant difference in MAP and HR at 1 and 3 min after intubation compared to those before intubation in group R2 and R3(F = 3.65,4.12,P0.05). Conclusions 2.5~3.0μg/kg remifentanil with 2.5% sevoflurane without relaxants can provide clinically acceptable tracheal intubating conditions and stable hemodynamic.