Effects of different doses of remifentanil on hemodynamic response to anesthesia induction in healthy elderly patients.

OBJECTIVE: We compared the effects of three different doses of remifentanil infusion, which were performed for the induction of anesthesia in elder patients, on cardiovascular response.

RESEARCH DESIGN AND METHODS: The present study was designed as a randomized, prospective and double-blind study. A total of 90 ASA I-II patients over the age of 65 years were enrolled. The patients were randomly (by lot) assigned to receive one of the three doses of remifentanil infusion (0.1, 0.2 or 0.3 μg/kg/min) for two minutes. Subsequently, 0.5 mg/kg propofol was administered via IV route and 0.5 mg/kg rocuronium was administered via IV route at the time eyelash reflex disappeared. Intubation was performed after 2 minutes. Patients who had an allergy against opioids, were chronic substance users, were obese, expected to have difficult airway, had hypertension, or were receiving any drug influencing the cardiovascular system were excluded.

MAIN OUTCOME MEASURES: In this study after recording baseline values of heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP), these values were recorded at the 1st, 2nd, 3rd, 4th and 5th minutes of induction.

RESULTS: A significant increase was observed in heart rate at the 1st and 2nd minutes of induction versus baseline in the Remi 0.1 group and at the 2nd minute of induction versus baseline in the Remi 0.2 group, with no additional significant change in heart rate. A significant decrease was determined in the systolic, diastolic and mean arterial pressures in all groups from the 1st minute of induction of anesthesia to the pre-intubation period compared to baseline (p < .05).

CONCLUSIONS: It was determined that each dose of remifentanil used was quite high for patients of this age-group. ClinicalTrials.gov trial number: NCT02763098.