Small doses of remifentanil or sufentanil for blunting cardiovascular changes induced by tracheal intubation: a double-blind comparison

Casati, Andrea; Fanelli, Guido; Albertin, A.; Deni, Francesco; Danelli, G.; Grifoni, Federica Irene; Torri, G.

doi:10.1046/j.1365-2346.2001.0790e.x

Cited by 28 publications

(17 citation statements)

References 24 publications

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“…Various methods such as α or β adrenergic blockers, opioids, topical or systemic lignocaine are being used to attenuate hemodynamic response [13][14][15]. Dexmedetomidine possess anxiolytic, sedative, analgesic, and sympatholytic properties.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Samal

Pattnaik

Swain

et al. 2017

Asian J Pharm Clin Res

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Objectives: The airway instrumentation of direct laryngoscopy and tracheal intubation is powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. This study compared the efficacy intravenous dexmedetomidine and oral pregabalin premedication for attenuation of hemodynamic pressor response to laryngoscopy and intubation.Methods: A total of 60 patients of age group 20-50 years scheduled for elective surgeries under general anesthesia with American Society of Anesthesiologists physical Status I and II were divided into two groups each of 30. Group D received intravenous dexmedetomidine 1 mcg/kg over 10 minutes before induction, and Group P received oral pregabalin 150 mg 1 hr before intubation. Parameters observed were heart rate (HR) and mean arterial pressure (MAP) at baseline, after induction, immediately after intubation and then 5, 10, 15, and 30 minutes thereafter.Results: Attenuation of HR in group dexmedetomidine (78.12±10.0/minutes) immediately after intubation was statistically significant than group pregabalin (89.76±10.45/minutes). MAP significantly (p<0.05) decreased after intubation with dexmedetomidine. As compared to oral pregabalin, attenuation of HR and MAP was statistically significant till 30 minutes after intubation with intravenous dexmedetomidine. Conclusion:Intravenous dexmedetomidine 1 µg/kg is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Samal

Pattnaik

Swain

et al. 2017

Asian J Pharm Clin Res

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“…Among opioids, remifentanil (1.0 μg kg -1 ), alfentanil (10-20 μg kg -1 ), or fentanyl (0.5-1.0 μg kg -1 ) were reported to have the most stable effect on hemodynamic response to laryngoscopy and tracheal intubation, but they prolonged the recovery time. [6–8] Intranasal nitroglycerine attenuated the hypertensive response to laryngoscopy and intubation, but tachycardia was observed.…”

Section: Discussionmentioning

confidence: 99%

Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation

2011

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Background:Hemodynamic responses of laryngoscopy and laparoscopy should be attenuated by the appropriate premedication, smooth induction, and rapid intubation. The present study evaluated the clinical efficacy of oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy.Methods:A total of 180 healthy adult consented patients aged 35 to 52 years with American Society of Anesthesiologist (ASA) physical status I and II of both gender, who met the inclusion criteria for elective laparoscopic cholecystectomy, were randomized to receive placebo Group I, pregabalin (150 mg) Group II, or clonidine (200 μg) Group III, given 75 to 90 minutes before surgery as oral premedication. All groups were compared for preoperative sedation and anxiety level along with changes of heart rate and mean arterial pressure prior to premedication, before induction, after laryngoscopy, pneumoperitoneum, release of carbon dioxide, and extubation. Intraoperative analgesic drug requirement and any postoperative complications were also recorded.Results:Pregabalin and clonidine proved to have sedative and anxiolytic effects as oral premedicants and decreased the need of intraoperative analgesic drug requirement. Clonidine was superior to pregabalin for attenuation of the hemodynamic responses to laryngoscopy and laparoscopy, but it increased the incidence of intra-and postoperative bradycardia. No significant differences in the parameters of recovery were observed between the groups. None of the premedicated patient has suffered from any postoperative side effects.Conclusion:Oral premedication with pregabalin 150 mg or clonidine 200 μg causes sedation and anxiolysis with hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy, without prolongation of recovery time and side effects.

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“…Among opioids, remifentanil (1 μ g/kg), alfentanil (10–20 μ g/kg), or fentanyl (0.5–1.0 μ g/kg) were reported to have the most stable effect on hemodynamic response to laryngoscopy and tracheal intubation but they prolonged the recovery time. [9]…”

Section: Discussionmentioning

confidence: 99%

Pregabalin premedication - A new treatment option for hemodynamic stability during general anesthesia: A prospective study

et al. 2011

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Background:Hemodynamic responses of laryngoscopy, intubation, and pain are powerful noxious stimulus which should be attenuated by the appropriate premedication, smooth induction, and rapid intubation.Context:The oral pregabalin may attenuate the hemodynamic pressor response with intraoperative hemodynamic stability.Aims:The present study was designed to evaluate the clinical efficacy and safety of oral pregabalin for hemodynamic stability.Settings and Design:This is a prospective blind randomized controlled cohort observation study.Materials and Methods:The 80 adult consented patients of ASA grade I and II of either gender aged 24–54 years who met the inclusion criteria were randomized to receive oral pregabalin 150 mg or placebo capsule, given 60–75 min before surgery. Patients were premedicated with metoclopramide (10 mg), glycopyrrolate (0.2 mg), and fentanyl (1 μg/kg). Anesthesia was induced with propofol and rocuronium and maintained with isoflurane, nitrous oxide, and oxygen. Both groups were assessed for preoperative sedation and changes in heart rate and mean arterial blood pressure before and after the induction and 1, 3, 5, and 10 min after laryngoscopy and intubation, then at 5 min intervals till end of surgery along with postoperative complications.Statistical Analysis:The hemodynamic variables were analyzed by using analysis of variance (ANOVA), Student's t test, and chi square test as appropriate.Results:Preoperative sedation was higher with pregabalin with no significant change in heart rate. The mean arterial pressure was attenuated with oral pregabalin to statistically significant value (P<0.007). The requirement of analgesic drug was reduced with no postoperative respiratory depression, nausea, or vomiting and hemodynamic parameters remained stabilized perioperatively.Conclusions:Oral pregabalin premedication effectively leads to sedation and analgesia with successful attenuation of the adverse and deleterious hemodynamic pressor response.

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Small doses of remifentanil or sufentanil for blunting cardiovascular changes induced by tracheal intubation: a double-blind comparison

Cited by 28 publications

References 24 publications

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation

Pregabalin premedication - A new treatment option for hemodynamic stability during general anesthesia: A prospective study

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