{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:21:07Z","timestamp":1789683667839,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T00:00:00Z","timestamp":1708732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004257","name":"Helse Vest","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004257","name":"Helse Vest","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Remifentanil may have a dose\u2010dependent haemodynamic effect during the induction of general anaesthesia combined with propofol. Our objective was to investigate whether systolic arterial blood pressure (SAP) was reduced to a greater extent when the remifentanil dose was increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomised, double\u2010blind, dose\u2010controlled study was conducted at the Day Surgery Unit of Haugesund Hospital, Norway. Ninety\u2010nine healthy women scheduled for gynaecological surgery were randomly allocated in a 1:1:1 ratio to receive remifentanil induction with a low, medium or high dose corresponding to maximum effect\u2010site concentrations (Ce) of 2, 4 and 8\u2009ng\/mL. The induction dose of propofol was 1.8\u2009mg\/kg, with a Ce of 2.9\u2009\u03bcg\/mL. Anaesthesia was induced using target\u2010controlled infusion. After 150\u2009s of sedation, a bolus of remifentanil and propofol was administered. Baseline was defined as 55\u20135\u2009s before the bolus dose, and the total observation time was 450\u2009s. We used beat\u2010to\u2010beat haemodynamic monitoring with LiDCOplus. The primary outcome variable was the maximum decrease in SAP within 5\u2009min after bolus administration of remifentanil and propofol. Absolute and relative changes from baseline to minimal values and the area under the curve (AUC) were used as effect measures. Comparisons of groups were performed using analysis of variance (ANOVA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median remifentanil doses were 0.75, 1.5 and 3.0\u2009\u03bcg\/kg in the low\u2010, medium\u2010 and high\u2010dose groups, respectively. The absolute changes (mean\u2009\u00b1\u2009standard deviation) in SAP in the low\u2010, medium\u2010 and high\u2010dose groups of remifentanil were \u221239\u2009\u00b1\u20099.6 versus \u221243\u2009\u00b1\u20099.1, and \u221241\u2009\u00b1\u200910\u2009mmHg, respectively. No difference (95% confidence interval) in the absolute change in SAP was observed between the groups (ANOVA, <jats:italic>p<\/jats:italic>\u2009=\u2009.29); medium versus\u00a0low dose 3.7 (\u22122.0, 9.4) mmHg, and high versus\u00a0medium dose \u22122.2 (\u22128.0; 3.5) mmHg. The relative changes from baseline to minimum SAP values were \u221230% versus\u00a0\u221232% versus\u00a0\u221232% (<jats:italic>p<\/jats:italic>\u2009=\u2009.52). The between\u2010group differences in the AUC were not statistically significant. Relative changes in heart rate (\u221220% vs. \u221221% vs. \u221221%), stroke volume (\u221219% vs. \u221216% vs. \u221216%), cardiac output (\u221232% vs. \u221232% vs. \u221232%), systemic vascular resistance (\u221224% vs. \u221227% vs. \u221228%), and AUC were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This trial demonstrated major haemodynamic changes during the induction of anaesthesia with remifentanil and propofol. However, we did not observe any statistically significant differences between low, medium or high doses of remifentanil when using continuous invasive high\u2010accuracy beat\u2010to\u2010beat monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14394","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T11:20:45Z","timestamp":1708773645000},"page":"601-609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Haemodynamic effects of remifentanil during induction of general anaesthesia with propofol. A randomised trial"],"prefix":"10.1111","volume":"68","author":[{"given":"Gunnar Helge","family":"Sj\u00f8en","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Fonna Hospital Trust  Haugesund Norway"},{"name":"Department of Research and Innovation Fonna Hospital Trust  Haugesund Norway"},{"name":"Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragnhild S\u00f8rum","family":"Falk","sequence":"additional","affiliation":[{"name":"Oslo Centre for Epidemiology and Biostatistics, Research Support Services Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor Hugo","family":"Hauge","sequence":"additional","affiliation":[{"name":"Norwegian Ministry of Trade, Industry and Fisheries  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor Inge","family":"T\u00f8nnessen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"},{"name":"Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care Oslo University Hospital, Rikshospitalet  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldrid","family":"Langes\u00e6ter","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care Oslo University Hospital, Rikshospitalet  Oslo 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