Hemodynamic effect of remifentanil on stress response to tracheal intubation: correlations with quantitative EEG analysis

摘要

Objective: In the present study we aimed to investigate the effect of remifentanil on hemodynamic responses occurring at intubation and correlation of these data with EEG analysis. Method: After approval of the Hospital's Ethics Committee, ten patients (aged 20±7) were included in the study. Before the operation, noninvasive blood pressure, heart rate and EEG measures of patients were all recorded. Anesthesia was induced with 2 mg/kg of propofol, 0.25 μgr/kg of remifentanil, and 0.15mg/kg of cis-atracurium. Heart rates, systolic-diastolic blood pressures and EEG waves were recorded after induction and tracheal intubations and 5 minutes after intubations. EEG waves were evaluated as qualitatively and by direct visual inspection of the raw data. Results: Systolic-diastolic blood pressures decreased after induction of anesthesia (p<0.01) but no alterations were determined in heart rates. A statistically significantly differences were found between the hemodynamic measures recorded after tracheal intubation and after anesthesia induction (p<0.05). Anesthesia induction was associated with an increase in delta activity (p=0.00) and a decrease in alpha (p<0.05) and beta (p=0.00) activities that were more prominent in the records obtained from posterior region of both hemispheres Tracheal intubations was associated with a significant decrease in delta activity (p=0.00) and an increase in an alpha and beta activites (p=0.01).The decrease in delta activities continued for 5 minutes after intubations (p<0.05). These EEG records were found concordant with the hemodynamic measures. Conclusion: In conclusion, we thought that EEG analysis and hemodynamic responses correlated well with each other on evaluation of the stress response during tracheal intubations and remifentanil use a decrease in this response.