Comparison of fentanyl and fentanyl plus lidocaine on attenuation of hemodynamic responses to tracheal intubation in controlled hypertensive patients undergoing general anesthesia.
BACKGROUND
Induction of anesthesia and endotracheal intubation often creates a period of hemodynamic instability in hypertensive patients. Endotracheal intubation of the trachea stimulates laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines.


OBJECTIVE
This trial aimed to evaluate and compare the efficacy of fentanyl and fentanyl plus lidocaine in attenuating the hemodynamic responses to laryngoscopy and endotracheal intubation in hypertensive patients.


METHODS
We conducted a prospective, randomized, double-blind trial in 37 patients with hypertension in the Rasoul-Akram Hospital, Tehran, Iran, from March to December 2011. The patients were randomly divided into two groups (fentanyl group and fentanyl plus lidocaine group). The fentanyl group received 2 mcg/kg and the fentanyl plus lidocaine group received 1.5mg lidocaine and 2mcg/kg fentanyl. Hemodynamic variables were recorded at baseline, after giving inductive anesthetic agents, and 1, 3 and 5 minutes after performing endotracheal intubation.


RESULTS
We evaluated 37 patients including 15 males (40.54%) and 22 females (59.46%), with a mean age of 56.08 ± 10.85 years. There were no significant differences between the two groups regarding; heart rate, systolic blood pressure and diastolic blood pressure before induction, 3 minutes before intubation and 1, 3 and 5 minutes after intubation.


CONCLUSIONS
Fentanyl and fentanyl plus lidocaine effectively decreased the hemodynamic response to tracheal intubation, however, neither fentanyl nor fentanyl plus lidocaine, could inhibit all hemodynamic responses, moreover fentanyl plus lidocaine was not more effective than fentanyl alone.
Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, Iran ; Minimally Invasive Surgery Research Center, Rasoul-Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Valiallah
V
Hassani
Gholamreza
G
Movassaghi
Vahid
V
Goodarzi
Saeid
S
Safari
Drug Stability; Fentanyl; Hemodynamics; Intratracheal; Intubation; Lidocaine