Effects Of Remifentanil On Haemodynamics And Stress Reaction During Induction Of Children Anaesthesia

Objective:To compare the effects of three different doses of remifentanil on haemodynamic and stress response to laryngoscopy and tracheal intubation during rapid sequence induction of children anaesthesia.Methods:Eighty ASAâ… -â…¡children aged 1-12 yrs weighing 8.5-32kg scheduled for elective operation were randomly assigned into groupâ… (Remifentanyl 1μg /kg),groupâ…¡(Remifentanil 1.5μg /kg),groupâ…¢(Remifentanil 2μg /kg)and groupâ…£(Fentanil 4μg /kg).Anaesthesia was induced with midazolam 0.05 mg/kg,propofol 2mg/kg and vecuronium 0.1 mg/kg,followed by remifentanil 1,1.5,2μg /kg or fentanil 4μg /kg respectively.Blood pressure and heart rate were recorded before induction lmin(T₀),just before intubation(T₁),immediately after intubation(T₂),3 min after intubation(T₃).The venous blood samples were taken to measure the plasma cortisol concentrations and blood glucoses before induction(T₁),immediately after intubation(T₂),5min after intubation(T₄)and after operation finished(T₅).Results:the SBP,DBP,HR,plasma cortisol concentrations and blood glucoses of all four groups obviously decreased after induction,but increased in groupsâ… andâ…¡after intubation,remaining the same in groupâ…¢andâ…£.Conlusion:Remifentil 2.0μg/kg administered with midazolam 0.05 mg /kg,propofol 2 mg/kg and vecuronium 0.1 mg/kg can significantly decrease haemodynamics and stress reaction during induction of chlidren anaesthesia,but should be careful of the incidences of adverse effects such as hypotension and HR deceased.