ABSTRACT
BACKGROUND: In spite of its minimal invasiveness, hemodynamic instability frequently happens during arthroscopic procedures. This study was performed to investigate the clinical efficacy of remifentanil for controlling the intra-operative hemodynamics during the performance of arthroscopic shoulder surgery. METHODS: Sixty patients (ASA class 1 and 2) who were scheduled for arthroscopic shoulder surgery were recruited for this study. After the induction and maintenance of anesthesia with thiopental sodium, rocuronium bromide, sevoflurane and nitrous oxide, the patients were randomly allocated to receive either saline or three different doses of remifentanil (0.03, 0.05 or 0.07 microg/kg/min) to assess the hemodynamic changes such as the systolic blood pressure, the diastolic blood pressure and the heart rate. RESULTS: The hemodynamics in the remifentanil groups were more stable than those in the saline group (P < 0.05), but there were some cardiovascular side effects such as hypertension (remifentanil 0.03 microg/kg/min), hypotension and bradycardia (remifentanil 0.07 microg/kg/min) with using remifentanil. CONCLUSIONS: Remifentanil 0.05 microg/kg/min under anesthetic maintenance with sevoflurane showed better hemodynamic stability than the other two remifentanil groups during arthroscopic shoulder surgery.