Effects of intravenous administration of fentanyl and lidocaine on hemodynamic responses following endotracheal intubation

Hashemian, Amir Masoud; Doloo, Hamid Zamani Moghadam; Saadatfar, Maziar; Moallem, Roya; Moradifar, Maryam; Faramarzi, Raheleh; Sharifi, Mohammad Davood

doi:10.1016/j.ajem.2017.07.069

Cited by 20 publications

(16 citation statements)

References 24 publications

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“…14 In order to blunt the responses to endotracheal intubation, various drugs have been used such as lignocaine and opioids and non-narcotic analgesics. 2,3 An ideal drug should be easily administered, have a rapid onset of action, relatively short duration of action, and be safe. Ideal drugs include fentanyl and alfentanil but unfortunately these drugs areunavailable in most hospitals in Pakistan.…”

Section: Discussionmentioning

confidence: 99%

“…have been tried to prevent hemodynamic changes but each drug has its own limitations. 2,3 Opioids are important drugs in the management of attenuation of hemodynamic response during intubation. Use of opioids before induction of general anesthesia makes the intraoperative course smooth and decreases the intraoperative requirement of anesthetic agents.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Faridi¹,

Nasir²,

Haider³

et al. 2020

TPMJ

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Laryngoscopy and tracheal intubation causes sympathetic over activity in the form of increased heart rate and blood pressure, which may lead to deleterious effects. Opioid drugs like fentanyl and nalbuphine are routinely used to attenuate this response during intubation. A few studies have claimed that acetaminophen is efficacious for this purpose too. Various studies have explored its role in blunting of pressor response but none have compared it with nalbuphine. We compared these drugs with the purpose, if both drugs are equally effective; acetaminophen would be a better alternative to nalbuphine without adverse effects of an opioid. Objectives: The objective of this study was to compare the efficacy of acetaminophen and nalbuphine in attenuating hemodynamic response during tracheal intubation. Study Design: Randomized, double-blind clinical trial. Setting: Main operation theatre complex of Fauji Foundation Hospital Rawalpindi. Period: From August to December 2018. Material & Methods: After obtaining permission from institutional ethical review committee of Fauji Foundation Hospital Rawalpindi. 60 Patients of ASA physical status I and II, aged 30 to 55 years, undergoing abdominal surgical procedure of 1 to 3 hour duration were randomly divided into two groups. Patients in group N received nalbuphine hydrochloride 0.15 mg/kg body weight intravenously, 30 minutes before induction. Patients in group P received acetaminophen infusion (paracetamol) 15mg/kg body weight intravenously, 30 minutes before induction. Systolic and diastolic blood pressures were measured manually and heart rate by pulse oximeter. Observations were made before giving analgesics, during induction, 1 minute after intubation, then at every 1- minute intervals till first 5 minutes, and thereafter at 10 minutes and at 15 minutes after intubation. The descriptive statistics of data were expressed as mean and standard deviation. Independent samples t-test was used for comparison of mean values of the variables in both groups. The value of p< 0.05 was considered as statistically significant. Results: There was a significant rise in heart rate and blood pressure after laryngoscopy and endotracheal intubation with acetaminophen (P group) as compared to the N group in which nalbuphine effectively reduced the tachycardia and hypertension. Conclusion: Acetaminophen has no significant effect on the prevention of hemodynamic changes due to intubation. Nalbuphine effectively reduces tachycardia and hypertension associated with laryngoscopy and endotracheal intubation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Faridi¹,

Nasir²,

Haider³

et al. 2020

TPMJ

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“…Kocamanoglu et al (15) reported that both IV and topical lidocaine limited the hemodynamic response in laryngoscopy and endotracheal intubation. Hashemian et al (16) reported that the combination of fentanyl and lidocaine is more effective than the use of fentanyl alone to prevent hemodynamic response due to intubation. In their study examining the effects of lidocaine on LMA insertion, Baik et al (17) detected that 1.5 mg/kg dose of lidocaine did not make hemodynamic changes, although the incidence of cough, gagging and laryngospasm was found to be decreased compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Lidocaine and Dexmedetomidine Before Propofol Induction During Laryngeal Mask Airway Insertion

Kavakli¹,

Kitapçıoğlu²

2019

eamr

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Objective: Laryngeal mask (LMA) is an airway device that can be used as an alternative to face mask and tracheal intubation. Different drug combinations can be used to ensure suitable conditions during LMA insertion. Lidocaine and dexmedetomidine are drugs that can be used to reduce hemodynamic response and suppress oropharyngeal reflexes during both intubation and LMA insertion. The aim of this study was to investigate the effects of lidocaine and dexmedetomidine on LMA insertion. Methods: Sixty patients who were scheduled to undergo cystoscopy under general anesthesia with LMA were included in the study. Patients were randomly divided into two groups: Group L (those who received 1.5 mg/kg lidocaine) and Group D (those who received 1 μg/kg dexmedetomidine). Number of attempts of LMA insertion, ease of LMA insertion, mouth opening, laryngospasm, gumming, stomach distention, limb movements and spontaneous breathing and hemodynamic parameters were recorded. Results: There was no statistically significant difference between the two groups in terms of the number of attempts of LMA insertion. In the first attempt, the LMA insertion success rate was 70% for Group L and 73.3% for Group D. There was no statistically significant difference between the two groups in terms of mouth opening, laryngospasm, ease of LMA insertion, gumming, stomach distension, limb movement and spontaneous breathing. Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate were statistically lower in Group D after drug administration. It was determined that the decreases in the other times were statistically significant compared to the baseline values after drug administration in both groups. Conclusion: Based on the results of the present study, 1 μg/kg dexmedetomidine and 1.5 mg/kg lidocaine used before propofol induction provided similar conditions for LMA insertion. Dexmedetomidine has a more hypotensive effect and provides a greater reduction in heart rate than lidocaine. Furthermore, the use of lidocaine before propofol induction provides better hemodynamic control than dexmedetomidine.

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“…However dose of lidocaine varies from 1.5 to 2 mg/kg. [17,18] We preferred to use 0.5-1 mg/kg dose in our clinical practice for induction of anesthesia in both cardiac and non-cardiac surgery. In our study we preferred to use 1 mg/kg for induction for standardization.…”

Section: Macintoshmentioning

confidence: 99%

“…[17] Intravenous administration of lidocaine is recommended for reducing hemodynamic responses to intubation, attenuation of cough reflexes, and intracranial and intraocular pressure. [18] Many studies have been conducted to reveal its effects on hemodynamic response to intubation. However dose of lidocaine varies from 1.5 to 2 mg/kg.…”

Section: Macintoshmentioning

confidence: 99%

Comparison of hemodynamic responses to endotracheal intubation with the GlideScope video laryngoscope and Macintosh laryngoscope in patients undergoing cardiovascular surgery

İnangil

Cansız

Gürbüz

et al. 2018

Turk Gogus Kalp Dama

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Effects of intravenous administration of fentanyl and lidocaine on hemodynamic responses following endotracheal intubation

Cited by 20 publications

References 24 publications

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Comparison of the Effects of Lidocaine and Dexmedetomidine Before Propofol Induction During Laryngeal Mask Airway Insertion

Comparison of hemodynamic responses to endotracheal intubation with the GlideScope video laryngoscope and Macintosh laryngoscope in patients undergoing cardiovascular surgery

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