title: Cardiovascular Response during Induction of Anesthesia and Tracheal Intubation with Thiopental added to Fentanyl, Ketamine, and Fentanyl-Ketamine.
abstract: BACKGROUND
  This investigation was performed to examine hemodynamic stability for the period of anesthesia induction and intubation, employing thiopental added to fentanyl, thiopental added to ketamine, and thiopental added to fentanyl and ketamine.
  
  
  METHODS
  Sixty adult patients were randomly assigned to one of three groups corresponding to the agents applied for induction: (a) thiopental (4 mg/kg) added to fentanyl (3microg/kg) (TF, n = 20), (b) thiopental (4 mg/kg) added to ketamine (0.1mg/kg) (TK, n = 20), and (c) thiopental (4 mg/kg) added to fentanyl (3microg/kg) and ketamine (0.1mg/kg) (TFK, n = 20). Hemodynamic responses were evaluated by determining changes in blood pressure (BP) and heart rate (HR) immediately before laryngoscopy and at 1, 3, 5, and 10 min after the beginning of laryngoscopy.
  
  
  RESULTS
  BP and HR changes throughout the induction of anesthesia tended to be larger in the TK group than in the TF and TFK groups (P < 0.05). After laryngoscopy, BP was significantly elevated in the TF and TK groups compared with TFK group (P < 0.05), the rank sequence remain TK > TF > TFK. Heart rate was significantly elevated in TK group compared with TF and TFK groups following laryngoscopy (P < 0.05), the rank sequence remain TK > TF > TFK. After intubation, BP and HR kept on unchanged matched up to with their pre-intubation levels in the TFK group.
  
  
  CONCLUSIONS
  A mixture of thiopental added to fentanyl added to ketamine would offer greater reduction of instabilities in hemodynamic variables related with induction of anesthesia and tracheal intubation than mixtures of thiopental added to fentanyl or thiopental added to ketamine.
authors: Department of Anesthesiology and Intensive Care, Alzahra Medical Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: A
authors: A
authors: Honarmand
authors: M
authors: M
authors: Safavi