Haemodynamic effects of remifentanil during induction of general anaesthesia with propofol. A randomised trial
Authors' conclusion
This trial demonstrated major haemodynamic changes during the induction of anaesthesia with remifentanil and propofol. However, we did not observe any statistically significant differences between low, medium or high doses of remifentanil when using continuous invasive high-accuracy beat-to-beat monitoring.
Study context
- Population
- Healthy women scheduled for gynaecological surgery, Day Surgery Unit, Haugesund Hospital, Norway; GA induced with propofol 1.8 mg/kg (concentrations (Ce) 2.9 μg/mL) by TCIrandomised 1:1:1
- Participants
- 99 women
- Comparison
- Remifentanil induction at low vs medium vs high dose with propofol
- Primary endpoint
- Maximum decrease in systolic arterial pressure (SAP) after bolus of remifentanil and propofol (beat-to-beat LiDCOplus monitoring)
- Follow-up
- Within 5 min after bolus
Methodological detailsdouble-blind, dose-controlled, single-centre
- Double-blind
- Dose-controlled
- Single-centre
Primary result
As reported in the abstract
Absolute change in SAP
Low
−39
mean · SD 9.6 · mmHg
Medium
−43
mean · SD 9.1 · mmHg
High
−41
mean · SD 10 · mmHg
Difference, mmHg (95% CI)
Medium vs Low
3.7(−2.0 to 9.4)
High vs Medium
−2.2(−8.0 to 3.5)
- No difference between groups (analysis of variance (ANOVA))
- P = 0.29
Further findings
Relative change from baseline to minimum SAP
- Relative changes −30% vs −32% vs −32% (low, medium, high)
- P = 0.52
AUC of SAP
- Between-group differences in AUC not statistically significant
Relative changes in heart rate, stroke volume, cardiac output, systemic vascular resistance
- Heart rate −20% vs −21% vs −21%
- Stroke volume −19% vs −16% vs −16%
- CO −32% vs −32% vs −32%
- Systemic vascular resistance −24% vs −27% vs −28%
- Differences (and AUC) not statistically significant
Original publication
Haemodynamic effects of remifentanil during induction of general anaesthesia with propofol. A randomised trial. Acta Anaesthesiol Scand. Published 24 February 2024. doi:10.
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