Key result
Administration of remifentanil 1.0 microg/kg before intubation prevented QTc interval prolongation associated with tracheal intubation, whereas saline and 0.5 microg/kg did not.
Why the study?
Does bolus administration of remifentanil prevent QTc interval prolongation in unpremedicated ASA grade 1 patients during induction of sevoflurane anaesthesia?
RCT (n=60)
Randomly allocated
Does bolus administration of remifentanil prevent QTc interval prolongation in unpremedicated ASA grade 1 patients during induction of sevoflurane anaesthesia?
A 1.0 microg/kg bolus of remifentanil administered before intubation prevents QTc prolongation associated with tracheal intubation during sevoflurane anesthesia.
Answers are grounded in this paper and cite their sources.
Supports 1.0 μg/kg remifentanil bolus to mitigate intubation-related QTc risk; confirms dose-dependent efficacy in sevoflurane induction.
Stimulation of the sympathetic nervous system associated with tracheal intubation causes corrected QT (QTc) interval prolongation. We postulated that the use of remifentanil during induction of anaesthesia might prevent this. Sixty unpremedicated, ASA grade 1 patients were selected and randomly allocated to receive either saline (group S), remifentanil 0.5 microg x kg(-1) (group R 0.5) or remifentanil 1.0 microg x kg(-1) (group R1.0) 1 min before laryngoscopy. The QTc interval was significantly prolonged immediately following intubation in group S and group R0.5, but it remained stable in group R1.0, compared with the QTc interval just before laryngoscopy. It is concluded that the administration of remifentanil 1.0 microg x kg(-1) before intubation can prevent the prolongation of the QTc interval associated with tracheal intubation during induction of anaesthesia with sevoflurane.
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Kweon et al. (2008) conducted an RCT in Induction of anaesthesia (n=60). Remifentanil vs. Saline was evaluated on QTc interval prolongation immediately following intubation. Administration of remifentanil 1.0 microg/kg before intubation prevented QTc interval prolongation associated with tracheal intubation, whereas saline and 0.5 microg/kg did not.
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