A Comparative Study of Hemodynamic Effects of Remifentanil with or without Atropine in Pediatric Day Case Surgery

Abstract

Background: Remifentanil is a short-acting opioid which is suitable for short-duration procedures such as bone marrow aspiration and biopsy; it’s known to cause bradycardia and hypotension; pre medicated of Atropine is important to decrease the incidence of bradycardia and hypotension. Aim of the study: to evaluate the hemodynamic effect of Remifentanil during bone marrow aspiration and biopsy in children with or without atropine. Methods: This is a prospective randomized, double-blind study included Eighty children .who were scheduled for B.M.A. they were allocated in two groups, forty children received atropine (group A), and forty received normal saline (group N) the H.R. and B.P. (S, D, M,) were monitored and recorded at specific time intervals: At induction before Remifentanil given, at time of Remifentanil given, T3, at recovery ( T. 6, T.9, T.12, T. 15) and at time of discharge. All children received Remifentanil 1 µg/kg. They injected over 30 Sc, a period followed by an infusion of 0.01 µg/kg/min. Result: Remifentanil cause a significant decrease in heart rate compared with the time of Remifentanil given, which is greater at (T.3) in the two groups. However, the values at recovery time (T.6, T.9, T.12, T.15) and at the time of discharge are highly significantly different between the two groups. In comparison with (T.3), there was a significant fall in B.P. (systole and mean ), the values at recovery (T.6, T.9, T.12, T.15 ) and at the time of discharged are significantly different in the two groups in which P value less than 0.01 means highly significant. And P. Value between 0.02-0.05 means significant, while the P. Value more than 0.05 is not significant Conclusion: Remifentanil produced a fall in B.P. and H. R . so the use of premedication Atropine decrease the incidence of bradycardia and hypotension in pediatric.