Remifentanil vs Esmolol During Intubation for Cerebral Aneurysm Coil Embolization

Starting soon · Not applicable

Conditions studied: Cerebral Aneurysm Unruptured, Intracranial Pressure

In brief

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.

Key facts

Study ID

NCT07660861

Run by

Fatih Sultan Mehmet Training and Research Hospital

People needed

84

Starts

2026-06-22

Expected to finish

2027-07-01

Last updated by the study team

2026-06-22

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥18 years
• American Society of Anesthesiologists (ASA) physical status I-III
• Scheduled for elective cerebral aneurysm coil embolization under general anesthesia
• Planned endotracheal intubation
• Ability to provide written informed consent

You may not qualify if…

• Emergency procedures
• Hemodynamic instability before induction of anesthesia
• Severe cardiac conduction abnormalities or clinically significant arrhythmias
• Contraindication or allergy to remifentanil or esmolol
• Chronic opioid use or opioid dependence
• Known orbital disease, ocular trauma, or conditions interfering with optic nerve sheath diameter measurements
• Anticipated difficult airway
• Pregnancy
• Refusal to participate in the study

Where it is running

• Fatih Sultan Mehmet Training and Research Hospital — Istanbul, Istanbul, Turkey (Türkiye)

Full record on ClinicalTrials.gov

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