The effects of remifentanil on haemodynamic stability during rigid bronchoscopy

We examined the effect of remifentanil on the haemodynamic response to rigid bronchoscopy in 22 adult ASA 2–4 patients, randomly allocated to receive 1.0  µ g.kg −1 remifentanil over 1 min followed by 0.5  µ g.kg −1 .min −1 (remifentanil group) or 2.0  µ g.kg −1 fentanyl followed by a saline infusion (control group). Following the initial infusion, all patients received a sleep dose of propofol followed by rocuronium 0.6 mg.kg −1 and their lungs were ventilated using a Sander's injector attached to the rigid bronchoscope. Direct arterial blood pressures, heart rate and ST segment changes on the CM 5 lead configuration of the electrocardiograph were measured at 1‐min intervals from before induction of anaesthesia until the end of bronchoscopy. Arterial pressures and heart rate were similar in the two groups before and after induction of anaesthesia. Remifentanil attenuated the haemodynamic response to bronchoscopy (p < 0.05 for increases in arterial pressures and heart rate). Four patients in the remifentanil group had ST segment depression compared with eight patients in the control group, but this was not statistically significant.