Specify the Effect of Intranasal and Intravenous Remifentanil on Hemodynamic Changes After Induction and Tracheal Intubation and Comparing with Control Group

Document Type : Original Article(s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Laryngoscopy and endotracheal intubation can cause noxious stimulation and increased hemodynamic complications. The aim of this study was to specify the effect of intranasal and intravenous remifentanil on hemodynamic changes after induction and tracheal intubation and comparing it with a control group.
Methods: In this randomized double-blind clinical trial study patients aged 18-65 undergoing general anesthesia, were enrolled from Kashani, AL-Zahra and Amin hospitals in Isfahan during 2018-2019. Patients were divided into three groups: intranasal (IN) remifentanil 4 μg/kg, intravenous (IV) remifentanil 0.5 μg/kg, NS serum with an equivalent volume injected as the remifentanil in the patient groups. Hemodynamic parameters of patients were recorded at baseline, 1 and 3 minutes after induction, and right before laryngoscopy, 1, 3, 5, and 10 minutes after laryngoscopy. ANOVA and chi-square tests were applied to analyze the data.
Findings: No significant difference was observed in the hemodynamic changes of patients including systolic and diastolic blood pressure, mean arterial blood pressure, heart rate, arterial oxygen as well as laryngoscopy grade, duration of anesthesia, surgeon's satisfaction and duration of laryngoscopy between the intravenous and intranasal drug groups (P > 0.05). However, the mean of all variables was significantly different between the study groups (P < 0.05).
Conclusion: Nasal remifentanil, like intravenous remifentanil, was effective in preventing hemodynamic changes during endotracheal intubation and in blunting the associated stimulatory response. The findings of this study can be useful in the healthcare domain.

Highlights

Seyed Mohammad Reza Safavi: Google Scholar

Azim Honarmand: Google Scholar

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References

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Journal of Isfahan Medical School
Volume 43, Issue 817
1st Week, August
July and August 2025
Pages 598-607

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History

  • Receive Date: 13 May 2025
  • Accept Date: 24 June 2025

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