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

J. T. Kim, J. K. Shim, S. H. Kim, H. G. Ryu, Seung-Zhoo Yoon, Y. S. Jeon, J. H. Bahk, C. S. Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

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 μg/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 μg/kg, but not lignocaine 1.5 mg/kg, effectively attenuates the haemodynamic response to endotracheal intubation during rapid sequence induction using propofol.

Original languageEnglish
Pages (from-to)20-23
Number of pages4
JournalAnaesthesia and Intensive Care
Volume35
Issue number1
Publication statusPublished - 2007 Feb 1
Externally publishedYes

Fingerprint

Propofol
Lidocaine
Intubation
Randomized Controlled Trials
Hemodynamics
Arterial Pressure
Intratracheal Intubation
Unconsciousness
Heart Rate
Glycopyrrolate
Laryngoscopy
Succinylcholine
Nitrous Oxide
remifentanil
Anesthesia
Oxygen
Pressure
Lung
Pharmaceutical Preparations

Keywords

  • Intubation
  • Lignocaine
  • Propofol
  • Remifentanil

ASJC Scopus subject areas

  • Medicine(all)
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

Remifentanil vs. lignocaine for attenuating the haemodynamic response during rapid sequence induction using propofol : Double-blind randomised clinical trial. / Kim, J. T.; Shim, J. K.; Kim, S. H.; Ryu, H. G.; Yoon, Seung-Zhoo; Jeon, Y. S.; Bahk, J. H.; Kim, C. S.

In: Anaesthesia and Intensive Care, Vol. 35, No. 1, 01.02.2007, p. 20-23.

Research output: Contribution to journalArticle

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abstract = "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 μg/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 μg/kg, but not lignocaine 1.5 mg/kg, effectively attenuates the haemodynamic response to endotracheal intubation during rapid sequence induction using propofol.",
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