Comparison between dexmedetomidine and fentanyl bolus in attenuating the stress response to laryngoscopy and tracheal intubation: a randomized double-blind trial

Mahiswar, Aditya P.; Dubey, Prakash K.; Ranjan, Alok

doi:10.1016/j.bjane.2021.02.060

Cited by 8 publications

(10 citation statements)

References 23 publications

(26 reference statements)

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“…Only one study compared fentanyl, dexmedetomidine, and lidocaine [11]. All other studies have compared only fentanyl and dexmedetomidine [12][13][14][15][16][17][18]. In this meta-analysis, lidocaine was ignored, as the aim of this meta-analysis was to compare fentanyl and dexmedetomidine.…”

Section: Resultsmentioning

confidence: 99%

“…neurosurgical procedure [12], and cardiac surgery [18]. All other studies included all kinds of elective surgical procedures [13][14][15][16][17]. Two reviewers assessed the risk of bias and it was found to be perfectly consistent, which showed that the overall quality of the study was moderate.…”

Section: Resultsmentioning

confidence: 99%

“…All eight studies reported HR at baseline [11][12][13][14][15][16][17][18]. The meta-analysis results showed no significant difference in HR between the two groups at baseline (MD = 1.48; 95% CI: -0.84, 3.81; P = 0.21, I 2 = 53%), as shown in Figure 3.…”

Section: Hr At Baselinementioning

confidence: 99%

“…The meta-analysis results showed no significant difference in HR between the two groups at baseline (MD = 1.48; 95% CI: -0.84, 3.81; P = 0.21, I 2 = 53%), as shown in Figure 3. Source: [11][12][13][14][15][16][17][18].…”

Section: Hr At Baselinementioning

confidence: 99%

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Comparison of Fentanyl and Dexmedetomidine in Preventing an Increase in Heart Rate During Intubation Among Patients Undergoing General Anesthesia: A Meta-Analysis

Mohsin¹,

Ganaie²,

Kundi³

et al. 2022

Cureus

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General anesthesia induction, tracheal intubation, extubation, and laryngoscopy are associated with specific hemodynamic changes. Tracheal intubation and laryngoscopy are related to sympathetic stimulation and lead to hypertension and tachycardia. Recent studies have shown that dexmedetomidine is safe and effective as it does not depress respiratory function. This meta-analysis aims to compare the efficacy of dexmedetomidine and fentanyl in preventing an increase in heart rate (HR) during intubation among patients undergoing general anesthesia. A systematic literature search was done using PubMed, Cochrane Library, and Embase to assess studies comparing the efficacy of dexmedetomidine and fentanyl in preventing an increase in HR during intubation. A meta-analysis was done utilizing a random-effects model, and mean differences of HR were determined between fentanyl and dexmedetomidine at baseline, one minute, five minutes, and 10 minutes of intubation. In this meta-analysis, eight randomized control trials were included, involving 548 patients (274 in the fentanyl group and 274 in the dexmedetomidine group). The findings showed that significant difference of HR was significantly lower in the dexmedetomidine group than the fentanyl group at one minute of intubation (mean difference = -8.46; P-value = 0.003), at five minutes of intubation (mean difference = -7.51; P-value = 0.001), and at 10 minutes of intubation (mean difference = -5.15; P-value = 0.030). In the current meta-analysis, dexmedetomidine was better than fentanyl in preventing tachycardia following endotracheal intubation. HR was significantly lower at one minute, five minutes, and 10 minutes after intubation in the dexmedetomidine group compared to the fentanyl group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Hr At Baselinementioning

confidence: 99%

Section: Hr At Baselinementioning

confidence: 99%

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Comparison of Fentanyl and Dexmedetomidine in Preventing an Increase in Heart Rate During Intubation Among Patients Undergoing General Anesthesia: A Meta-Analysis

Mohsin¹,

Ganaie²,

Kundi³

et al. 2022

Cureus

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“…In present study, group I had 15 males and 10 females and group II had 8 males and 17 females. Mahiswar et al [8] in their study one hundred patients admitted for routine surgical procedures under general anesthesia were enrolled into two groups: Group F received injection of fentanyl 2 µg.kg-1 and Group D received injection of dexmedetomidine 0.5 µg.kg-1 diluted up to 5 mL by adding normal saline intra-venously over 60 seconds. The difference in heart rate and mean arterial pressure of patients in two groups after laryngoscopy and intubation was not statistically significant at any point of time.…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of bolus dose of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses following laryngoscopy and intubation

Sheikh¹,

Ara²

2021

Int. J. Adv. Res. Med.

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Background: Laryngoscopy and tracheal intubation lead to tachycardia and hypertension due to increase in the plasma concentration of catecholamines subsequent to sympathetic stimulation. The present study was conducted to compare bolus dose of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses following laryngoscopy and intubation. Materials & Methods: 50 patients of ASA status I and II of both genderswere divided into two groups. Group I received 1 mcg/kg of Inj. Dexmedetomidine in 100 ml of normal saline over 10 minutes and 5ml of normal saline 3 minutes before induction. Group II received 100 ml of normal saline over 10 minutes and Inj. Fentanyl 2 mcg/kg diluted in 5 ml of normal saline 3 minutes before induction. Results: The mean SBP was 92.5 mm Hg in group I and 93.2 mm Hg in group II, DBP was 58.2 mm Hg in group I and 62.1 mm Hg in group II. MAP was 69.0 mm Hg in group I and 72.2 mm Hg in group II, heart rate was 62.9 bets/min in group I and 70.4 beats/minute in group II. The difference was significant (P< 0.05). Conclusion: Bolus injection of dexmedetomidine 1mcg/kg given intravenously over 10 minutes prior to intubation provided consistent and reliable protection against the pressor response during laryngoscopy and endotracheal intubation.

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Secuencia rápida de inducción e intubación: una revisión narrativa

Martínez-Hurtado

Aristizábal-Hincapié²,

Zamudio³

2022

Iatreia

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A pesar de los avances tecnológicos y el desarrollo de habilidades no técnicas, las muertes prevenibles por fallas en el manejo avanzado de la vía aérea aún son un problema en la atención del paciente inestable. Una de las estrategias descritas para mejorar el porcentaje de éxito de la intubación al primer intento, y posiblemente disminuir complicaciones, es la secuencia rápida de inducción e intubación, una intervención compleja que requiere preparación del personal de salud. Desde su descripción original han existido profundizaciones, nuevas intervenciones y cambios, por lo que existe la necesidad de hacer una síntesis de estas evidencias. En este artículo se presenta una revisión narrativa sobre el tema basada en una búsqueda no sistemática, la cual resultó en una aproximación a las acciones e intervenciones más representativas a criterio de los autores, resaltando la valoración de la vía aérea, la preparación de los equipos críticos, el adecuado posicionamiento según el tipo de población, las estrategias de preoxigenación, la preestabilización de la causa subyacente, el resumen de los medicamentos inductores y relajantes neuromusculares, las estrategias alternas de intubación, como la videolaringoscopia, y los cuidados posintubación, que incluyen la estrategia de fijación de doble vector y parámetros iniciales de ventilación.

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Comparison between dexmedetomidine and fentanyl bolus in attenuating the stress response to laryngoscopy and tracheal intubation: a randomized double-blind trial

Cited by 8 publications

References 23 publications

Comparison of Fentanyl and Dexmedetomidine in Preventing an Increase in Heart Rate During Intubation Among Patients Undergoing General Anesthesia: A Meta-Analysis

Comparison of Fentanyl and Dexmedetomidine in Preventing an Increase in Heart Rate During Intubation Among Patients Undergoing General Anesthesia: A Meta-Analysis

A comparative analysis of bolus dose of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses following laryngoscopy and intubation

Secuencia rápida de inducción e intubación: una revisión narrativa

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