The effect of increasing the dose of buprenorphine on the haemodynamic response associated with tracheal intubation

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The effect of buprenorphine on the haemodynamic response to tracheal intubation was studied at two dose levels, 2.5 micrograms.kg-1 and 5 micrograms.kg-1, in a placebo-controlled double-blind trial in 75 patients undergoing laparoscopic cholecystectomy. The study drugs were administered intravenously 8 min before induction of anaesthesia with thiopentone 5 mg.kg-1 and vecuronium 0.1 mg/kg-1. Buprenorphine 2.5 micrograms.kg-1 caused 50% attenuation of the blood pressure response whereas 5 micrograms/kg-1 caused 70% attenuation compared to the saline placebo. The maximum increase in heart rate was 14% of the control value after 2.5 micrograms.kg-1 and 11% after 5 micrograms/kg-1 of buprenorphine. A significant difference in heart rate was also observed between the two buprenorphine groups at 5 and 10 min after intubation. Blood pressure and heart rate both showed a significant fall from baseline values 10 min after intubation in both buprenorphine groups, with the changes being greater in the 5 micrograms.kg-1 group. We recommend the use of 2.5 micrograms.kg-1 buprenorphine for attenuation of the hypertensive response to intubation in major abdominal surgery.