thanks, very useful post, but do you know any literature support in using remi and fenta together?thanks

HI what I wanted to say is that in my experience remi is not so easy to titrate in some patients ( generally old people ) I use usually remi alone but in some case I have seen profound ipotension just after intubation and at relatively low dosing (0,25 mcg/kg/min) and in 2 cases (young people) stiffness, that I never see using the old fashioned 100mcg of fenta. In these patients I feel safer by using fenta for induction and then if necessary starting the remi ( or giving more fenta). My question is : is there any support to my practice ( literature or something ) or not? thanks

hi, I have the habit to start the GA by using fentanil 2mcg/kg for the induction and then start the remifentanil infusion. I feel not safe to start with remifentanil ( I had an episode of tremendous stiffness) do you think this practice is correct? Do you have any clinical evidence to support or not this practice ?( I never had problems)
thanks
Simone