Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium

Cisatracurium provides superior hemodynamic stability with only minor release of histamine, and its metabolism via Hoffman elimination is independent of organ function. However, use of cisatracurium is limited because of reportedly slower onset and unsatisfactory intubating conditions. Many studies...

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Main Authors:	Jeong, Hye Jin, Lee, Seong Heon, Kim, Hwi Jin, Kwak, Sang Hyun
Format:	Online
Language:	English
Published:	Chonnam National University Medical School 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434798/

id	pubmed-3434798
recordtype	oai_dc
spelling	pubmed-34347982012-09-13 Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium Jeong, Hye Jin Lee, Seong Heon Kim, Hwi Jin Kwak, Sang Hyun Original Article Cisatracurium provides superior hemodynamic stability with only minor release of histamine, and its metabolism via Hoffman elimination is independent of organ function. However, use of cisatracurium is limited because of reportedly slower onset and unsatisfactory intubating conditions. Many studies have shown that remifentanil might provide reliable intubating conditions; thus, we hypothesized that pretreatment with remifentanil before administration of cisatracurium might result in acceptable intubating conditions. Sixty healthy patients scheduled for elective surgery were enrolled and randomly divided into three groups: saline (Group I, n=20), remifentanil 0.5 µg/kg (Group II, n=20), and remifentanil 1.0 µg/kg (Group III, n=20). The anesthesia was induced with propofol 2.0 µg/kg given intravenously over 30 s followed by injection over 30 s of a different dose of remifentanil according to the study protocol. We examined the intubating condition by jaw relaxation, vocal cord state, and diaphragmatic response 90 s after administering cisatracurium. We also measured mean blood pressure, heart rate, and the onset time, which is the interval from the end of neuromuscular blocking agent administration until suppression of maximal T1 on a train-of four sequence. The mean values of the intubating condition after endotracheal intubation in Groups II and III were significantly lower than that in Group I (p<0.005), although the overall onset time of cisatracurium did not differ significantly between the three groups. Our results suggest that supplementation with remifentanil in an induction regimen with cisatracurium improves the quality of the intubating condition even though the onset time of cisatracurium is not shortened. Chonnam National University Medical School 2012-08 2012-08-24 /pmc/articles/PMC3434798/ /pubmed/22977750 http://dx.doi.org/10.4068/cmj.2012.48.2.96 Text en © Chonnam Medical Journal, 2012 http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Jeong, Hye Jin Lee, Seong Heon Kim, Hwi Jin Kwak, Sang Hyun
spellingShingle	Jeong, Hye Jin Lee, Seong Heon Kim, Hwi Jin Kwak, Sang Hyun Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
author_facet	Jeong, Hye Jin Lee, Seong Heon Kim, Hwi Jin Kwak, Sang Hyun
author_sort	Jeong, Hye Jin
title	Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
title_short	Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
title_full	Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
title_fullStr	Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
title_full_unstemmed	Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium
title_sort	effects on intubating conditions of pretreatment with remifentanil before administration of cisatracurium
description	Cisatracurium provides superior hemodynamic stability with only minor release of histamine, and its metabolism via Hoffman elimination is independent of organ function. However, use of cisatracurium is limited because of reportedly slower onset and unsatisfactory intubating conditions. Many studies have shown that remifentanil might provide reliable intubating conditions; thus, we hypothesized that pretreatment with remifentanil before administration of cisatracurium might result in acceptable intubating conditions. Sixty healthy patients scheduled for elective surgery were enrolled and randomly divided into three groups: saline (Group I, n=20), remifentanil 0.5 µg/kg (Group II, n=20), and remifentanil 1.0 µg/kg (Group III, n=20). The anesthesia was induced with propofol 2.0 µg/kg given intravenously over 30 s followed by injection over 30 s of a different dose of remifentanil according to the study protocol. We examined the intubating condition by jaw relaxation, vocal cord state, and diaphragmatic response 90 s after administering cisatracurium. We also measured mean blood pressure, heart rate, and the onset time, which is the interval from the end of neuromuscular blocking agent administration until suppression of maximal T1 on a train-of four sequence. The mean values of the intubating condition after endotracheal intubation in Groups II and III were significantly lower than that in Group I (p<0.005), although the overall onset time of cisatracurium did not differ significantly between the three groups. Our results suggest that supplementation with remifentanil in an induction regimen with cisatracurium improves the quality of the intubating condition even though the onset time of cisatracurium is not shortened.
publisher	Chonnam National University Medical School
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434798/
_version_	1611554476851724288

Effects on Intubating Conditions of Pretreatment with Remifentanil before Administration of Cisatracurium

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