Effect of remifentanyl combined with esmolol on cardiovascular response during endotracheal intubation under general anesthesia

Abstract

Objective To evaluate effect of remifentanyl combined with esmolol on cardiovascular response during endotracheal intubation under general anesthesia. Method sixty patients (ASA Ⅰ~Ⅱ) who undergoing elective surgery were randomly divided into 3 groups (n = 20): remifentanyl 2 μg/kg (Group Ⅰ), fentanyl 4 μg/kg combined with esmolol 1 mg/kg (Group Ⅱ) and remifentanyl 2 μg/kg combined with esmolol 1 mg/kg (Group Ⅲ). After intravenous admistration of the above drugs and propofol 2 mg/kg and atracurium 1.5 mg/kg, endotracheal tube was intubated and mechanical verntilation was performed. Heart rate (HR), systolic pressure(SP) and diastolic pressure (DP) were recorded before induction (T1), 1 min after induction (T2), at the onset of endotracheal intubation (T3), 1 min after intubation(T4), 3 min after intubation (T5) and 10 min after intubation (T6). And arterial blood sample was taken at T1, T2 and T3 for detecting the levels of serum adrenaline and noradrenaline. Result HR, SP, DP and serum levels of adrenaline and noradrenaline were significantly lower than those in Group Ⅰ(P < 0.05). HR, SP and DP in Group Ⅲ were lower than Group Ⅱ. HR, SP and DP at T3 were significantly higher than those at other time points in Group Ⅰ(P < 0.05), but there were no significant difference in those variables between Group Ⅱ and Group Ⅲ. Conclusion Remifentanyl combined with esmolol can prevent cardiovascular response during endotracheal intubation of patient under general anesthesia. Key words: Remifentanyl; esmolol; endotracheal intubation; adrenaline; noradrenaline