Comparison of Remifentanil and Fentanyl Regarding Hemodynamic Changes Due to Endotracheal Intubation in Preeclamptic Parturient Candidate for Cesarean Delivery

Background: Intravenous opioids are administered to prevent and control hemodynamicchanges due to endotracheal intubation. Except for special cases such as preeclampsia,these drugs are not recommended for parturants candidate for cesarean sectionbecause of the respiratory depression caused in the newborn.Objectives: According to rapid metabolism of remifentanil, the current study aimed tocompare hemodynamic changes in preeclamptic parturants who received remifentaniland fentanyl for cesarean section under general anesthesia.Patients and Methods: This single blind randomized clinical trial was performed onpreeclamptic pregnant women candidate for cesarean section under general anesthesia.They were divided into two groups. In the first group 0.05 µg/kg/min remifentanil wasinfused for 3 minutes before induction of anesthesia and in the second group 1ml (50 µg)fentanyl was injected before induction. Heart rate (HR), systolic blood pressure (SBP) anddiastolic blood pressure (DBP) before and after intubation and also Apgar index weremeasured and compared between the two groups.Results: All hemodynamic variables increased after intubation in the fentanyl group(pSBP = 0.146, pDBP = 0.019, pHR 0.001). Additionally, decrease in SBP (P = 0.018) andDBP (P = 0.955) and mild increase in HR (P = 0.069) after intubation in the remifentanilgroup was observed. No significant difference was found between Apgar indexes of thetwo groups (P = 0.771).Conclusions: It can be postulated that remifentanil can be used in partituents candidatefor cesarean delivery under general anesthesia to prevent severe increase in blood pressureand heart rate during tracheal intubation without adverse effects on newborn.