Efficacy and safety of remifentanil in a rapid sequence induction in elderly patients: A three-arm parallel, double blind, randomised controlled trial
| Autor: | Jean-Yves Lefrant, Arnaud Chaumeron, Patrick Basset, L.-P. Fortier, Jeremie Castanie, Sandrine Alonso, Sophie Bastide, Philippe Cuvillon |
|---|---|
| Přispěvatelé: | Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Polyclinique du Grand Sud [Nîmes], Unité de réanimation médicale [CHU de Carémeau, Nîmes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital Maisonneuve-Rosemont, BESPIM, Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Tachycardia
Adverse event medicine.medical_treatment Heart rate Remifentanil Blood Pressure Critical Care and Intensive Care Medicine Placebo law.invention Induction 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Double-Blind Method 030202 anesthesiology Etomidate law medicine Intubation Intratracheal Intubation Humans Rapid Sequence Induction and Intubation Aged Aged 80 and over business.industry Hemodynamics 030208 emergency & critical care medicine General Medicine Rapid sequence induction 3. Good health Anesthesiology and Pain Medicine Anesthesia Rapid sequence medicine.symptom business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug |
| Zdroj: | Anaesthesia Critical Care & Pain Medicine Anaesthesia Critical Care & Pain Medicine, Elsevier Masson, 2020, 39 (2), pp.215-220. ⟨10.1016/j.accpm.2019.09.010⟩ |
| ISSN: | 2352-5568 |
| DOI: | 10.1016/j.accpm.2019.09.010⟩ |
| Popis: | International audience; Background: Rapid sequence induction (RSI) is recommended in patients at risk of aspiration, but induced haemodynamic adverse events, including tachycardia. In elderly patients, this trial aimed to assess the impact of the addition of remifentanil during RSI on the occurrence of: tachycardia (primary outcome), hypertension (due to intubation) nor hypotension (remifentanil).Methods: In this three-arm parallel, double blind, multicentre controlled study, elderly patients (65 to 90 years old) hospitalised in three centres and requiring RSI were randomly allocated to three groups, where anaesthesia was induced with etomidate (0.3mg/kg) followed within 15seconds by either placebo, or low (0.5μg/kg), or high (1.0μg/kg) doses of remifentanil, followed by succinylcholine 1.0mg/kg. Heart rate (HR) and mean arterial pressure (MAP) were recorded before induction and after intubation.Results: In total, eighty patients were randomised and analysed. Baseline HR and MAP were similar between groups. For primary endpoint, the absolute change in HR between induction and intubation was greater in the control group (15 bpm; 95% CI [8-21]) than that in the remifentanil 0.5μg/kg group (4 bpm; 95% CI [-1-+8]; P=0.005) and the remifentanil 1.0μg/kg group (-3 bpm; 95% CI [-9-+3]; P |
| Databáze: | OpenAIRE |
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