The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

Teong, Cheng Yeon; Huang, Chien-Chung; Sun, Fang‐Ju

doi:10.1038/s41598-020-65711-9

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…9 Fentanyl has been used to blunt the hemodynamic changes related to laryngoscopy and intubation. 10 The rationale for using fentanyl at 1 or 2 µg/kg in our trial was as follows: (i) During general inhalational anesthesia, fentanyl 1-2 µg/kg IV was used as a supplement; (ii) In an effort to minimize sudden circulatory alterations in response to numerous surgical stimuli, fentanyl 2-10 µg/kg IV was used; and (iii) The usage of low-dose fentanyl to reduce cardiovascular compromise after intubation has been suggested in many trials. 11 The suppressive effects of fentanyl on tachycardia can explain the rationale of its use in this setting, since HR is the key controllable determinant of myocardial oxygen balance.…”

Section: Discussionmentioning

confidence: 99%

Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

Salman¹,

Zayed²,

Mansour³

et al. 2021

APIC

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Background: Both tracheal intubation and extubation are associated with dangerous consequences such as tachycardia, hypertension, myocardial ischemia and arrhythmias. The aim was to evaluate pre–extubation two different doses of fentanyl on hemodynamic stabilization and delayed recovery in mastectomy. Methodology: The randomized controlled double–blind study was conducted on 126 patients aged 16–60 years, with controlled hypertension, receiving chemotherapy before surgery and underwent mastectomy for breast cancer. Patients were randomly allocated into 3 equal groups. Before extubation, patients received 10 ml saline in group (C), 1 µg/kg fentanyl in Group–F1: and 2 µg/kg fentanyl in Group–F2. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at T1 (after maintenance of anesthesia), T2 (after giving the test drug), T3 (immediately after extubation), T4 (5 min. after extubation) and T5 (15 min after extubation). Results: MAP was significantly lower in fentanyl groups compared to Group–C at T2 and T3 without significant deference between fentanyl groups. HR was significantly lower in fentanyl groups compared to Group–C and in Group–F2 compared to Group–F1 at T3, T4 and T5. Time of extubation was significantly prolonged in Group–F2 compared to Group–F1 and Group–C without a significant difference between Group–F1 and Group–C. Conclusions: Pre–extubation fentanyl 1 µg/kg blunted cardiovascular responses to extubation without respiratory depression or prolonged recovery. Pre–extubation fentanyl 2 µg/kg provide more control in HR but with delay in the extubation time compared to 1 µg/kg of fentanyl. Key words: Pre–Extubation, Fentanyl, Mastectomy, Hemodynamics, Recovery Preregistration: The study was registered in the Ethical Committee of Faculty of Medicine, Cairo University, Cairo, Egypt (approval number: 281) Citation: Salman A, Zayed NO, Mansour A, Howaidi R, Foly AG, ElSharkawy MS, Abdelgalil AS. Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study. Anaesth. pain intensive care 2021;25(2):143-149. DOI: 10.35975/apic.v25i2.1462. Abbreviations: CST=Craniosacral therapy; SMT=Sensorimotor training; NCLBP=Nonspecific chronic low back pain; VAS=Visual analogue scale; ODI=Oswestry disability index, BDI-II=Beck depression inventory-II, and SF-36=Short Form-36; CSF=cerebral spinal fluid; CSS=craniosacral system; PRM=primary respiratory movements Received: 27 June 2020, Reviewed: 24 July 2020, Accepted: 27 July 2020

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Section: Discussionmentioning

confidence: 99%

Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

Salman¹,

Zayed²,

Mansour³

et al. 2021

APIC

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“…1 There is a necessity to blunt this response to prevent deleterious effects like arrhythmias, myocardial ischemia, increased intracranial pressure, rupture of cerebral aneurysm etc. 2 Various drugs like intravenous lidocaine, adrenergic blocking drugs like alpha blockers and beta blockers, vasodilators like nitroprusside, nitroglycerin, hydralazine and intravenous opioids are used for attenuation of hemodynamic response to laryngoscopy and tracheal intubation. Various studies have already discovered that fentanyl 2mcg/kg is effective in attenuating this cardiovascular responses.…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have already discovered that fentanyl 2mcg/kg is effective in attenuating this cardiovascular responses. [2][3][4][5][6][7] However, in this studies thiopentone 3 and propofol 6 are used as induction agents. Very few studies have been carried out to determine the ideal dose of fentanyl for attenuation of this hemodynamic response with etomidate as an induction agent.…”

Section: Introductionmentioning

confidence: 99%

The comparative efficacy of two different doses of fentanyl on hemodynamic response to laryngoscopy and tracheal intubation: Prospective, randomized control trail

Patel¹,

Patel²,

Patel³

et al. 2022

IJCA

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General anaesthesia with muscle relaxants using controlled ventilation involves laryngoscopy and tracheal intubation, which is associated with haemodynamic changes in the form of tachycardia and hypertension due to increased sympathoadrenal activity and are probably of no consequence in healthy individuals, but they may be hazardous to those with Myocardial Insufficiency and cerebrovascular disease. The objective of the present study was to compare the effect of two different doses of fentanyl with etomidate as an induction agent in attenuating haemodynamic stress response during laryngoscopy and endotracheal intubation. A randomised control trial was carried out on 60 adult patients (ASA I, II, III) undergoing elective surgery under general anaesthesia requiring endotracheal intubation. The patients were randomly allocated into two groups of 30 each i.e. group F2.5 and group F5 receiving fentanyl 2.5μg/kg and 5 μg/kg intravenously five minutes before intubation respectively. The pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded at various time intervals up to ten minutes after intubation. The study showed that both the doses were equally effective in blunting the pulse rate response, but the 5μg /kg proved significantly effective in blunting the blood pressure response. The rate pressure product, a measure of cardiac O2 consumption was found to be significantly lower in fentanyl 5μg/kg compared to fentanyl 2.5μg/kg. Hence, we conclude that fentanyl in 5 mcg/kg dose is more effective in attenuating hemodynamic responses to intubation as compared to 2.5 mcg/kg.

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“…Endotracheal intubation and extubation are stressful and are associated with cardiovascular stimulation. 1,2 Other disadvantages of tracheal intubation include hemodynamic reactions to laryngoscopy and damage to oropharyngeal structures during insertion with and postoperative sore throat.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia

Shibin

Priyamkari

2022

Int J Res Med Sci

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Background: Supra glottic airway devices (SGAD) is integral to airway management during general anesthesia. PLMA, a second-generation SGAD with a gastric channel and an efficient seal, is an alternative for the COETT, which is the gold standard for securing the airway.SGAD has the advantage of lesser hemodynamic changes during insertion and removal. This study aimed to compare the hemodynamic and ventilatory changes between PLMA and the endotracheal tube (ETT).Methods: Prospective randomized study, conducted at Yenepoya medical college hospital on 90 patients undergoing elective laparoscopic surgeries under general Anaesthesia. The patients were divided into groups; group p=45 patients (PMLA) and E=45 patients (COETT). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2) and end-tidal carbon dioxide (EtCO2) were documented at baseline, at 1, 3, 5 and 8 minutes after placement of airway device. Results: Differences in vital parameters at baseline were statistically insignificant. HR, SBP, DBP and MAP were significantly higher in group E compared to group P at 1st, 3rd, 5th and 8 min after the insertion of the airway device. There was no statistically significant difference in SpO2 and EtCO2. Post-extubation laryngopharyngeal morbidity was noted in 5 patients with ETT compared to 1 patient with PMLA.Conclusions: PLMA provides better hemodynamic stability at insertion when compared to ETT. Both PLMA and ETT provide good oxygenation and ventilation during elective laparoscopic surgeries. Insertion at first attempt was more successful with PLMA when compared to ETT.

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The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

Cited by 15 publications

References 26 publications

Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

The comparative efficacy of two different doses of fentanyl on hemodynamic response to laryngoscopy and tracheal intubation: Prospective, randomized control trail

Comparative study of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia

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