Low dose fentanyl attenuates hypertension but not tachycardia during laryngoscopy and tracheal intubation in a three arm study
Journal Title: International Archives of Integrated Medicine - Year 2016, Vol 3, Issue 4
Abstract
Background: Tracheal intubation may induce; hypertension, tachycardia, and/or arrhythmia. Fentanyl is a frequently used opioid that joins with hypnotic agents to diminish hemodynamic responses to tracheal intubation. Furthermore, lidocaine has a suppressive effect on the circulatory responses in patients undergoing laryngoscopy and tracheal intubation. However, intravenous lignocaine has shown variable results and large doses of fentanyl causes hypotension and cough. We compared the effectiveness of intravenous lignocaine 1.5 mg/kg bolus and intravenous fentanyl 2 mcg/kg bolus in attenuating the sympathetic response to laryngoscopy and tracheal intubation. Materials and methods: One hundred and fifty ASA physical status I or II patients undergoing elective, non-cardiac procedures were randomized, to one of the three treatments such as either normal saline or lignocaine 2 mg/kg or fentanyl 2 mcg/kg. Intubation was carried out 3 minutes after administration of these study drugs. Patients received Midazolam before induction, and Thiopental, Rocuronium during anesthesia. The heart rate, blood pressure and SPO2 were recorded a day before (B), before intubation (0) at 1 2 3 4-5 minutes after induction. Results: Tachycardia (HR>100 beats/min) after intubation was statistically similar across 85% (17/20), 75% (15/20) and 55% (11/20) saline, lignocaine, and fentanyl respectively (p>0.05). Hypertension (SBP > 180 mmHg) was seen in 80% (16/20), 70% (14/20) and 40% (8/20) with saline, lignocaine and fentanyl respectively. The incidence of hypertension with fentanyl was significantly (p<0.05) lower than saline; however, such a meaning was not observed with lignocaine. Conclusion: Low dose of fentanyl prevented hypertension but not tachycardia as compared to normal saline; on the other hand, lignocaine did not attenuate cardiovascular responses during laryngoscopy and tracheal intubation.
Authors and Affiliations
Valluri Anil Kumar, Vaddineni Jagadish, Netra Chavali
Keywords
Related Articles
- EP ID EP419880
- DOI -
- Views 101
- Downloads 0
A prospective single blinded randomized study to assess post operative analgesia using ultrasound guided transverse abdominis plane block for laparoscopic appendectomy
Introduction: Pain is one of the most important factors that is responsible for many adverse outcomes during surgery and in postoperative period. Effective pain control can also facilitate rehabilitation and accelerate r...
Cytomorphometric analysis of oral squames Tobacco Smoker’s using oral brush biopsy: An exfoliative cytological study
Background: Tobacco is mostly regarded as one of the primary etiologic factor in causing oral cancer. Literature quotes studies have depicted the alteration of nuclear (NA) and cytoplasmic area (CA) induced by tobacco sm...
Plantar fasciitis: Outcome evaluation of plantar fasciitis treated with PRP against steroid injection
Plantar fasciitis is the most common cause of heel pain which seems difficult to treat in its most chronic and severe forms. Earlier treatments, including orthoses, non steroidal anti-inflammatory drugs, and steroid inje...
Role of Therapeutic endoscopy vs surgery in the management of traumatic pancreatic injury - A tertiary referral center experience
Background: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic...
Pseudotumor cerebri in 11 months old child – A case report with review of literature
Pseudotumor cerebri is defined as a clinical entity where there are signs and symptoms of raised intracranial pressure but the higher mental and neurological functions are not altered. Many times the etiology is unknown....