Comparison of dexmedetomidine and remifentanil for attenuation of hemodynamic responses to laryngoscopy and tracheal intubation

• Published in: Korean journal of anesthesiology Vol. 63; no. 2; pp. 124 - 129
• Main Authors: Lee, Jeong Han, Kim, Hyojoong, Kim, Hyun-Tae, Kim, Myoung-Hun, Cho, Kwangrae, Lim, Se Hun, Lee, Kun Moo, Kim, Young-Jae, Shin, Chee-Mahn
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01.08.2012; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: Clinical; dexmedetomidine; endotracheal intubation; hemodynamics; remifentanil; 마취과학; Hemodynamics; Endotracheal intubation; Remifentanil; Dexmedetomidine
• ISSN: 2005-6419; 2005-7563; 2005-7563
• DOI: 10.4097/kjae.2012.63.2.124

This study was designed to compare the effect of dexmedetomidine and remifentanil used in anesthetic induction on hemodynamic change after direct laryngoscopy and tracheal intubation. A total of 90 ASA class 1 or 2 patients were randomly assigned to one of 3 groups to receive one of the following treatments in a double-blind manner: normal saline (Group C, n = 30), dexmedetomidine 1 µg/kg (Group D, n = 30), remifentanil 1 µg/kg (Group R, n= 30). Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.6 mg/kg and maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. In group D, dexmedetomidine 1 µg/kg was infused for 10 min before tracheal intubation. Patients in group R was received 1 µg/kg of remifentanil 1 minute before tracheal intubation. The systolic blood pressure, diastolic blood pressure and heart rate were recorded from entrance to operation room to 5 min after tracheal intubation. The percent increase in systolic and diastolic blood pressure due to tracheal intubation in group D and R were significantly lower than that of group C (P < 0.05). The heart rate 1 min after tracheal intubation was lower in groups R and D than in the group C (P < 0.05). In healthy normotensive patients, the use of dexmedetomidine during anesthetic induction suppressed a decrease in blood pressure due to anesthetic induction and blunted the hemodynamic responses to endotracheal intubation.