Assessment of small-dose fentanyl and sufentanil blunting the cardiovascular responses to laryngoscopy and intubation in children.
BACKGROUND
The authors found no study assessing the efficacy of small-dose narcotics on the cardiovascular response from intubation in children, so they observed the effects of fentanyl 2 microg x kg(-1) and sufentanil 0.2 microg x kg(-1) on the cardiovascular changes during laryngoscopy and intubation in children.


METHODS
Ninety-three children aged 3-9 years were randomized to one of three groups to receive the following treatments in a double-blind manner: normal saline (group C), fentanyl 2 microg x kg(-1) (group F) and sufentanil 0.2 microg x kg(-1) (group S) 2 min before induction. Noninvasive blood pressure (BP) and heart rate (HR) were recorded before anesthesia induction (baseline value), immediately before intubation (postinduction values), at intubation and 5 min after intubation at 1-min interval.


RESULTS
Tracheal intubation caused significant increases in BP and HR in the three groups compared with baseline values. BP and HR at intubation and after intubation and their maximum values during observation were significantly lower in groups F and S than in group C (P < 0.05). The mean percent increases of systolic blood pressure (SBP) and HR at intubation were significantly lower in group S, 7% and 10%, than in group F, 17% and 25% (P < 0.05). The increases in SBP and HR of more than 30% of baseline values during the observation period were significantly higher in group F, 27% and 43%, than in group S, 0% and 3% (P < 0.05).


CONCLUSIONS
When used as part of anesthesia induction with propofol in children, sufentanil 0.2 microg x kg(-1) 2 min before induction is more effective in attenuating the cardiovascular intubation response than fentanyl 2 microg x kg(-1).
Xue
Fu Shan
FS
Xinxiang Medical College, Xingxiang, Henan, China. fruitxue@yahoo.com.cn
Liu
Kun Peng
KP
Liu
Yi
Y
Xu
Ya Chao
YC
Liao
Xu
X
Zhang
Guo-Hua
GH
Li
Cheng-Wen
CW
Yang
Quan Yong
QY
Sun
Hai-Tao
HT
D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D012965:Sodium Chloride / Q000008:administration & dosage; D017409:Sufentanil / Q000494:pharmacology*; D013997:Time Factors; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D012965:Sodium Chloride; D017409:Sufentanil; D005283:Fentanyl