Fentanyl Citrate 2 mcg/ kg and 4 mcg/kg in Attenuation of Hemodynamic Responses During Intubation

What is it about?

Fentanyl Citrate 2 mcg/ kg and 4 mcg/kg in Attenuation of Hemodynamic Responses During Intubation

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Photo by Oli Woodman on Unsplash

Photo by Oli Woodman on Unsplash

Why is it important?

Background: Laryngoscopy and intubation in the lightly anesthetized patient is associated with significant increase in blood pressure and heart rate. These changes occur from reflex sympathetic discharge resulting from pharyngeal and laryngotracheal stimulation with increases in plasma concentration of epinephrine and norepinephrine. This reaction is not prevented by regular premedication. This study was designed to compare the two different doses of fentanyl citrate that is 2 mcg/kg and 4 mcg/kg in attenuation of hemodynamic effects during laryngoscopy and intubation. Methods: 80 adult patients 40 in each group ranging from 18–60 years of age and from both sexes undergoing modified radical mastectomy and total and subtotal thyroidectomy and surgeries which include oral intubation were selected for the study. Only patients belonging to ASA 1 and 2 were selected for the study. Group 1: Receives Inj. Fentanyl Citrate 2 mcg/kg. Group 2: Receives Inj, Fentanyl Citrate 4 mc/kg. All the parameters including heart rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure were recorded at the time of intubation and sequencially 1 min, 3 min, 5 min, and 10 minutes after intubation. Results: We studied all 4 parameters in both the Groups in all the patients and found out that the heart rate slightly increased during intubation in the Group 1 patients while it was either remained stable or decreased in Group 2 patients. There is consistent decrease in SBP, DBP and MBP in both the Groups from the baseline throughout the study period, and maximum decrease in all the pressures found at 10 minutes interval in Group 2 patients. Conclusion: Fentanyl citrate given 5 minutes before intubation produces most attenuation of the hemodynamic effects of stress response. Pretreatment with fentanyl citrate in every normal case would cause attenuation of hemodynamic effects of laryngoscopy and intubation. It will cause minimal change in heart rate, SBP, DBP, MAP, RPP during the first 10 minutes after intubation. Fentanyl citrate in 2 mcg/kg significantly attenuate but fentanyl 4 mcg/kg completely attenuates the hemodynamic responses during laryngoscopy and intubation.

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