Effects of fentanyl-lidocaine-propofol and dexmedetomidine-lidocaine-propofol on tracheal intubation without use of muscle relaxants.
The aim of this study was to compare the effects of fentanyl or dexmedetomidine when used in combination with propofol and lidocaine for tracheal intubation without using muscle relaxants. Sixty patients with American Society of Anesthesiologists stage I risk were randomized to receive 1 mg/kg dexmedetomidine (Group D, n = 30) or 2 mg/kg fentanyl (Group F, n = 30), both in combination with 1.5 mg/kg lidocaine and 3 mg/kg propofol. The requirement for intubation was determined based on mask ventilation capability, jaw motility, position of the vocal cords and the patient's response to intubation and inflation of the endotracheal tube cuff. Systolic arterial pressure, mean arterial pressure, heart rate and peripheral oxygen saturation values were also recorded. Rate pressure products were calculated. Jaw relaxation, position of the vocal cords and patient's response to intubation and inflation of the endotracheal tube cuff were significantly better in Group D than in Group F (p < 0.05). The intubation conditions were significantly more satisfactory in Group D than in Group F (p = 0.01). Heart rate was significantly lower in Group D than in Group F after the administration of the study drugs and intubation (p < 0.05). Mean arterial pressure was significantly lower in Group F than in Group D after propofol injection and at 3 and 5 minutes after intubation (p < 0.05). After intubation, the rate pressure product values were significantly lower in Group D than in Group F (p < 0.05). We conclude that endotracheal intubation was better with the dexmedetomidine-lidocaine-propofol combination than with the fentanyl-lidocaine-propofol combination. However, side effects such as bradycardia should be considered when using dexmedetomidine.
Hanci
Volkan
V
Department of Anesthesiology and Reanimation, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey. vhanci@gmail.com
Erdoğan
Gülay
G
Okyay
Rahşan Dilek
RD
Yurtlu
Bülent Serhan
BS
Ayoğlu
Hilal
H
Baydilek
Yunus
Y
Turan
Işil Ozkoçak
IO
D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D020927:Dexmedetomidine; D008012:Lidocaine; D005283:Fentanyl; D015742:Propofol
J Neurosurg Anesthesiol. 2005 Apr;17(2):97-9
15840996
Br J Anaesth. 1992 Jun;68(6):570-5
1351736
J Clin Anesth. 2007 Aug;19(5):370-3
17869990
Anaesthesia. 1997 Aug;52(8):736-44
9291757
Paediatr Anaesth. 2005 Sep;15(9):762-6
16101707
Br J Anaesth. 1992 Feb;68(2):126-31
1347229
Anesth Analg. 2005 Oct;101(4):1248
16192567
J Clin Anesth. 2004 Mar;16(2):124-6
15110375
J Clin Anesth. 2007 Mar;19(2):141-4
17379129
Can J Anaesth. 2005 Aug-Sep;52(7):776-7
16103401
Anesth Analg. 2003 May;96(5):1336-1339
12707129
Can J Anaesth. 2003 Jun-Jul;50(6):607-10
12826556
Anesthesiology. 2006 Nov;105(5):902-10; quiz 1069-70
17065883
Acta Anaesthesiol Scand. 2006 Nov;50(10):1314-5
17067342
Eur J Anaesthesiol. 1998 Nov;15(6):714-8
9884858
Life Sci. 1981 Jun 29;28(26):2981-6
6115298
Masui. 2008 Jun;57(6):731-4
18546903
Eur J Anaesthesiol. 2008 Aug;25(8):675-80
18400141
Acta Anaesthesiol Scand. 2005 Sep;49(8):1088-91
16095449
Drugs R D. 2006;7(1):43-52
16620136
Eur J Pharmacol. 1992 Jan 14;210(2):173-81
1350992
AANA J. 2008 Feb;76(1):41-5
18323319
Anesthesiology. 2004 Feb;100(2):359-63
14739811
Anesth Analg. 1998 Jan;86(1):45-9
9428849
Can J Anaesth. 2003 Feb;50(2):108-15
12560298
Can J Anaesth. 2000 May;47(5):427-32
10831199
Can J Anaesth. 2003 Feb;50(2):116-20
12560299
Can J Anaesth. 2005 Mar;52(3):249-53
15753494
Anesth Analg. 1997 Jun;84(6):1222-6
9174296