BACKGROUND: Laryngoscopy and tracheal intubation may cause hemodynamic changes, such as hypertension and tachycardia. Moreover, opioids are the most widely used drugs for hemodynamic stability. The purpose of this study was to determine the optimal dosage of alfentanil required to attenuate hemodynamic changes during anesthesia induction with propofol.

METHODS: 120 ASA class 1-2 patients, scheduled for elective surgery, were divided randomly into 6 groups. Anesthesia was induced with propofol (2µg/kg) followed by rocuronium (0.9µg/kg). The control group received no alfentanil, and the study groups received 5, 10, 15, 20, or 25µg/kg of alfentanil, respectively. Systolic blood pressure, mean arterial blood pressure, diastolic blood pressure and heart rate were measured preinduction (base), after propofol induction, immediately before & after intubation, and 1, 2, 3, 4, 5 minutes after intubation, respectively. Results: After intubation, the increased heart rate and blood pressure were higher in the control and A5 groups, and this increased heart rate was not suppressed in the A10 group. The incidences of bradycardia and hypotension were also higher in the A20, and A25 groups. Conclusions: When anesthesia is induced with propofol, we suggest that the dosage of alfentanil for attenuating hemodynamic change during tracheal intubation be about 15mug/kg.