Comparison of remifentanil and alfentanil effects on the modynomic responses to induction of anesthesia and tracheal intubation in elderly patients

Background & objective: With consideration that laryngoscopy and tracheal intubation leades to hemodynamic responses in the forms of hypertension and tachycardia and olso arrhythmia and myocardial ischemia and this alternations can be life-threatening in elderly patients, this clinical trial study had comparised the effects of two rapid-onset narcotic, alfentanil and remifentanil on the hemodynamic responses to induction and tracheal intubation in elderly patients. Methods: This double-blind clinical trial studied 40 elderly more than 65 patients condidated to cataract surgery with general anesthesia. The patients were divided randomly into two groups of 20 and for first group, Alfentanil 10 g/kg and for second group remifentanil 0.5 g/kg was injected 30 seconds before induction. The method of anesthesia was same for two groups and during the anesthesia, the first group took infusion of alfentanil 1 g/kg/min and second group remifentanil 0.1 g/kg/min. The heart rate, systolic, diastolic and mean arterial blood pressure was measured and recorded before induction, after injection of drugs, after intubation and during the minutes. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi squre and ANOVA. Results: Immediately after injection of narcotic drugs all hemodynamic variants decreased noticeably, but decrease of diastolic blood pressure in remifentanil group significantly was more than alfentanil group (P<0.05). After layngoscopy and tracheal intubation all hemodynamic variants increased and slowly decreased after first minutes. Systolic, diastolic and mean arterial blood pressure decreased significantly in remifentanil group more than alfentanil group (P<0.05). At the first minutes after intubation, the decreasing of heart rate had not significant difference between two groups (P>0.05). Also the using of ephedrin to treatment of severe hypotention in remifentanil group (11 patients) was significantly more than alfentanil group (4 patents) (P