Comparison Between Remifentanil And Fentanyl Effects on

Intravenous opioid injection as premedication is one of the most common methods for preventing and controlling hemodynamic changes due to laryngoscopy and tracheal intubation. Using such drugs is not suggestsd in pregnant women who candidate for cesarean section, because of respiratory depression in the newborn, but in special conditions such as preeclampsia, anesthetists can inject low doses of fentanyl(as a synthetic opioid). Because of rapid metabolism of remifentanil and no respiratory effects in the newborn, it can be introduced as a perfect alternative for longer acting opioids in such conditions. This study was done as a randomized clinical trial on preeclamptic pregnant women who were candidate for cesarean section under general anesthesia. They were divided into two groups: in one group 1ml. fentanyl was injected before induction of anesthesia(n1=18), and in the other group 0.05
g/kg/min remifentanil was infused for 3 minutes before induction (n2=20). Afterwars, of heart rate, systolic and diastolic blood pressures before and after intubation and also the newborn's apgar were measured and assessed. All hemodynamic indices increased after intubation in the fentanyl group, and increase in diastolic pressure an heart rate was significant. Mild increase in heart rate and decreasing in systolic and diastolic blood pressure after intubation in remifentanil group was achieved that the decrease in systolic blood pressure was significantly different(R1=154.35, R2=148.35). Comparison of changes between the two groups also demonstrated significant difference (Pval.<0.05). The newborns mean apgar score showed no signifant difference between the two groups(AP.remi=0.88, AP.fent=0.86). Discussion and Considering no difference between the newborns apgar in both the groups and results of assessment of hemodynamic indices, it can be suggested to use remifentanyl in pregnant women who are candidate for cesarean section under general anesthesia to prevent severe increase in blood pressure and heart rate during tracheal intubation.