Background: Remifentanil is an effective drug for protecting against adverse haemodynamic responses to tracheal\nintubation. We compared the haemodynamic responses during anaesthesia induction between continuous\nintravenous (IV) infusion and two bolus injections of remifentanil.\nMethods: This prospective, randomised, open-label, single-centre study included patients with American Society of\nAnesthesiologists physical status I-II, scheduled to undergo elective surgery under general anaesthesia. Patients\nwere randomised into two groups based on remifentanil administration type: the continuous IV infusion group\n(Group C) receiving a 0.3-�¼g/kg/min remifentanil infusion for 5 min followed by a 0.1-�¼g/kg/min remifentanil\ninfusion, and the IV bolus group (Group B) receiving a combination of two bolus injections of remifentanil (first\nbolus of 0.4 �¼g/kg and second bolus of 0.6 �¼g/kg after 3 min) and 0.1 �¼g/kg/min remifentanil. General anaesthesia\nwas induced with 1 mg/kg propofol and 0.6 mg/kg rocuronium 3 min after remifentanil infusion (Group C) or\nimmediately after the first bolus of remifentanil (Group B). Tracheal intubation was performed 4 min after the\ninjection of propofol and rocuronium. Heart rate and non-invasive blood pressure were recorded at 1-min intervals\nfrom baseline (i.e., before induction) to 5 min after tracheal intubation.\nResults: A total of 107 patients were enrolled (Group C, 55; Group B, 52). Normotensive patients with no history of\nantihypertensive medication use were assigned to the normotensive subgroup (41 each in both groups), while\nthose with hypertension but without a history of antihypertensive medication use were assigned to the untreated\nhypertensive subgroup (Group C vs. B, n = 7 vs. 4). Finally, patients with a history of antihypertensive medication use\nwere assigned to the treated hypertensive subgroup (7 each in both Groups C and B). No differences in heart rate\nand blood pressure were observed between Groups C and B within each subgroup.\nConclusions: Haemodynamic responses during anaesthesia induction were similar between continuous infusion and\ntwo bolus injections of remifentanil within both normotensive and hypertensive patients with or without medication.
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