Clinical Research Article Korean J Anesthesiol 2010 June; 58(6): 508-513 DOI: 10.4097/kjae.2010.58.6.508 Difference of the hemodynamic changes induced by tracheal intubation using remifentanil between smokers and nonsmokers Sang Hoon Sung, Soo Bong Yu, Doo Sik Kim, Kyung Han Kim, Tae Ho Jang, Se Hwan Kim, and Sie Jeong Ryu Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea Background: It was well-known that smoking affects the cardiovascular system, and remifentanil can suppress the sympathetic stimulations induced by tracheal intubation. The purpose of this study was to investigate whether there was any difference in the hemodynamic changes induced by tracheal intubation with using remifentanil between smokers and nonsmokers. Methods: Eighty patients were enrolled: male smokers (MS), male nonsmokers (MN), female smokers (FS) and female nonsmokers (FN). Anesthesia was induced with diluted remifentanil (20 μg/ml) at a rate of 10 μg/kg/hr using an infusion pump, and 2 min later, midazolam 0.05 mg/kg and propofol 0.8 mg/kg were injected for achieving unconsciousness. Rocuronium 1 mg/kg was used for muscle relaxation, and tracheal intubation was performed 2 min after rocuronium injection. After tracheal intubation, the remifentanil was decreased to 2 μg/kg/hr. The mean arterial pressure (MAP) and heart rate (HR) were checked before induction, on unconsciousness, just before intubation, just after intubation and 1, 2 and 3 minutes after intubation, and these values were compared between the groups. Results: In men, the MAP and HR just after intubation and at 1, 2 and 3 minutes after intubation in Group MS were significantly higher than those of Group MN (P < 0.05). For the women, the HR in both groups (the FS and FN groups) were increased just after intubation and 1, 2 and 3 minutes after intubation compared with that at the baseline, respectively, but there was no difference between the two groups. Conclusions: There was a difference of the hemodynamic changes induced by tracheal intubation with using remifentanil between the male smokers and nonsmokers, but not in women. (Korean J Anesthesiol 2010; 58: 508-513) Key Words: Hemodynamic change, Intubation, Nonsmoker, Remifentanil, Smoker. Received: February 3, 2010. Revised: 1st, February 24, 2010; 2nd, March 26, 2010. Accepted: April 13, 2010. Corresponding author: Sie Jeong Ryu, M.D., Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan 602-030, Korea. Tel: 82-51-990-6265, Fax: 82-51-254-2504, E-mail: siejeong@ns.kosinmed.or.kr Presented at the 86th Annual Scientific Meeting of the Korean Society of Anesthesiologists, Jeju, November 6-7, 2009. CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright ⓒ Korean Society of Anesthesiologists, 2010 www.ekja.org