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[Appropriate dose of remifentanil to blunt tracheal intubation stress response in patients with severe aortic stenosis].
Matsukawa, Shino; Ishii, Hisanari; Fukuda, Kazuhiko.
Afiliación
  • Matsukawa S; Department of Anesthesia, Kyoto University Hospital, Kyoto 606-8507.
Masui ; 61(8): 800-4, 2012 Aug.
Article en Ja | MEDLINE | ID: mdl-22991798
BACKGROUND: In anesthetic induction of patients with severe aortic stenosis, maintenance of normal heart rate and blood pressure is critical. Remifentanil can blunt cardiovascular responses to tracheal intubation, but may cause circulatory collapse due to potent vasodilating effect. We studied retrospectively the optimal dose of remifentanil, which blunts cardiovascular responses to tracheal intubation and provides the hemodynamic stability to patients with severe aortic stenosis. METHODS: We administerd remifentanil with three different doses (0.3 microg x kg(-1) x min(-1) : n=4, 0.5 microg x kg(-1) x min(-1): n=7, 1 microg x kg(-1) x min(-1): n=7) in anesthetic induction of patients with aortic stenosis. Systolic arterial blood pressure and heart rate before and after the tracheal intubation were recorded. The degree of change of post to pre-intubation of systolic arterial pressure and heart rate was calculated and compared among groups. RESULTS: There were no significant differences in background among the groups. The ratio between before and after tracheal intubation of systolic arterial pressure was significantly lower in the group of 0.5 microg x kg(-1) x min(-1) and 1 microg x kg(-1) x min(-1). There was no significant hypotension or bradycardia which may lead to severe cardiovascular depression. CONCLUSIONS: We found that more than 0.5 microg x kg(-1) x min(-1) of remifentanil can blunt cardiovascular responses to tracheal intubation without severe cardiovascular depression.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Piperidinas / Anestésicos Intravenosos / Hemodinámica / Hipnóticos y Sedantes / Intubación Intratraqueal Tipo de estudio: Observational_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: Ja Revista: Masui Año: 2012 Tipo del documento: Article Pais de publicación: Japón
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Piperidinas / Anestésicos Intravenosos / Hemodinámica / Hipnóticos y Sedantes / Intubación Intratraqueal Tipo de estudio: Observational_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: Ja Revista: Masui Año: 2012 Tipo del documento: Article Pais de publicación: Japón