Remifentanil vs Esmolol During Intubation for Cerebral Aneurysm Coil Embolization

Condition(s) studied

Investigational drug(s) / intervention(s)

Remifentanil: Remifentanil 0.5-1 µg/kg IV administered over 90 seconds before endotracheal intubation.

Esmolol: Esmolol 0.5-1 mg/kg IV administered over 90 seconds before endotracheal intubation.

Study summary

Endotracheal intubation may cause significant increases in blood pressure, heart rate, and intracranial pressure, particularly in patients undergoing cerebral aneurysm coil embolization. Remifentanil and esmolol are commonly used agents to attenuate these responses during anesthesia induction.

This randomized controlled trial aims to compare the effects of remifentanil and esmolol administered before endotracheal intubation on optic nerve sheath diameter/eyeball transverse diameter ratio (ONSD/ETD), a noninvasive surrogate marker of intracranial pressure, as well as hemodynamic responses in patients undergoing elective cerebral aneurysm coil embolization.

The findings may help identify the most effective strategy for minimizing intubation-related intracranial pressure changes and hemodynamic fluctuations in neurointerventional anesthesia practice.

Eligibility

Primary outcome measure(s)

• Change in ONSD/ETD Ratio at 5 Minutes After Endotracheal Intubation — 5 minutes after endotracheal intubation
  Difference between baseline (pre-intubation) and 5-minute post-intubation optic nerve sheath diameter-to-eyeball transverse diameter ratio (ONSD/ETD).

Trial sites (1)

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