Effects of different dosages of oxycodone and fentanyl on the hemodynamic changes during intubation

Abstract

Objectives:To investigate the effectiveness of oxycodone compared with fentanyl for attenuating the hemodynamic response during endotracheal intubation.Methods:This study was conducted from June 2014 to February 2015 on healthy adults undergoing general anesthesia at the Yeungnam University Hospital, Daegu, Republic of Korea. Ninety-five patients were randomly assigned to one of 3 groups to receive the following drugs; Group F: fentanyl 2 µg/kg; Group O/70: oxycodone 140 µg/kg; Group O/100: oxycodone 200 µg/kg. Five minutes after injection of the study drug, general anesthesia was induced with propofol 1.5 mg/kg and rocuronium 0.8 mg/kg. The mean blood pressure (MBP), heart rate (HR), peripheral oxygen saturation (SpO2), and bispectral index (BIS) were compared before administration of the study drug (T1), just before endotracheal intubation (T2), one minute after endotracheal intubation (T3), and 7.5 minutes after endotracheal intubation (T4). Complications were assessed.Results:The 2 oxycodone groups showed no significant differences in MBP, HR, SpO2, and BIS compared to Group F at the time points assessed. The incidence of complications was comparable among the groups.Conclusions:Oxycodone could successfully be used to attenuate the sympathetic response during anesthetic induction. The hemodynamic profiles and incidence of complications were clinically similar among the groups, but Group O/70 tended to show a lower rate of complications of apnea.

Preemptive Anti–Stress Response Effects of Oxycodone Versus Sufentanil for Patients Undergoing Cardiac Valve Replacement—A Randomized Controlled Trial

“…In addition, oxycodone has much weaker μ‐receptor affinity than sufentanil, which may mitigate the adverse reactions related to μ‐receptor agonist, such as respiratory distress and the like, compared with sufentanil . A prospective, randomized, clinical trial suggested that the pretreatment of oxycodone could successfully attenuate the sympathetic response during the period of anesthetic induction . Therefore, it is of great importance to investigate the effects of oxycodone on anti–stress response, hemodynamics changes, respiration, and sedation during the preparation period of anesthesia and surgery for patients undergoing cardiac valve replacement.…”

Safety and efficacy of intravenous oxycodone in geriatric patients undergoing general anesthesia for ophthalmic surgeries:a randomized controlled trial

“…Previous studies supported that oxycodone may offer advantages over fentanyl for pain control [9,10]. Recent data demonstrated that a lower dose of oxycodone was sufficient to control acute post-operative pain [22,23].…”

“…In recent decades, intravenous oxycodone has been used for perioperative pain management [7]. Comparing to morphine or fentanyl, intravenous oxycodone provides better pain relief, especially for visceral pain [8][9][10]. During induction of general anesthesia, previous studies have shown that the attenuation effect of oxycodone on hemodynamic responses is comparable to fentanyl, and the complication rates are also similar between these two opioids [10,11].…”

“…Comparing to morphine or fentanyl, intravenous oxycodone provides better pain relief, especially for visceral pain [8][9][10]. During induction of general anesthesia, previous studies have shown that the attenuation effect of oxycodone on hemodynamic responses is comparable to fentanyl, and the complication rates are also similar between these two opioids [10,11]. Other studies suggest that oxycodone may be associated with less sedation, less perioperative hemodynamic changes, and lower rate of hypoventilation when compared with morphine or fentanyl [8,10,12].…”

全麻诱导期经静脉输液管缓慢滴注和快速输注芬太尼对该药诱发呛咳的影响

“…However, fentanyl intravenous injection can cause the so called fentanyl-induced cough (FIC) during the induction, which may be explosive or even life-threatening (He et al, 2016;Park et al, 2016). It is particularly dangerous for those patients suffering from airway diseases, acute upper airway obstruction, cerebral aneurysm, increased intracranial pressure, brain trauma, brain hernia, or dissecting aortic aneurysm, as severe FIC could lead to pneumothorax, optic nerve injury, or rupture of aneurysms (Lim et al, 2013;Saleh et al, 2014;Firouzian et al, 2015;Park et al, 2016;Peringathara and Robinson, 2016). In clinical settings, the reported incidence of FIC is variable (18.0%-74.4%) depending on the dosage, infusion speed, and route of administration (Sedighinejad et al, 2013;Solanki et al, 2016).…”