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Assessment of tracheal intubation in children after induction with propofol and different doses of remifentanil

Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 µg.kg−1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg−1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 µg.kg−1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 µg.kg−1 were better than in those given remifentanil 1.0 µg.kg−1 (p < 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 µg.kg−1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 µg.kg−1 and in the control group (p < 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 µg.kg−1 (p < 0.001). In conclusion, remifentanil 2 µg.kg−1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.