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

Abstract

Background: The induction of anesthesia, laryngoscopy and endotracheal intubation can beassociatedwith adverse hemodynamic response. 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 with control group at therapeutic centers of Isfahan University of medical science in 2018-2019. 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 which are located in Isfahan (IRAN). Participants were divided into three groups to receive intranasal (IN) remifentanil 4μg/kg, intraveous (IV) remifentanil 0/5μg/kg, NS serum with equivalent volume of injected remifentanil as same as patient groups. Hemodynamic parameters of patients were recorded at the baseline, 1 and 3 minute after induction, right before laryngoscopy 1, 3, 5 and 10 minute after laryngoscopy. ANOVA and Chi-square test were applied to analyze the data. Findings: All hemodynamic changes of patients including systolic and diastolic blood pressure, mean arterial blood pressure, heart rate, arterial oxygen and laryngoscopic grade, duration of anesthesia, surgeon satisfaction and duration of laryngoscopy in the group receiving intravenous and nasal drugs compared to each other were not significantly different (P > 0.05). But the two groups receiving the drug had a pointedly difference in terms of all parameters compared to the control group (P < 0.05). Conclusion: Nasal remifentanil, as Intravenous Remifentanil, was effective in preventing hemodynamic changes during endotracheal intubation. The findings of this study can be useful for the health field. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.