Hemodynamic Responses to Tracheal Intubation in Elderly Patients: Intravenous or Spray of Lidocaine versus Fentanyl

Jalali, Alireza; Nasiri, Ebrahim; Khoramian, Mohsen; Saghafinia, Masood; Siamian, Hasan

doi:10.5455/medarh.2017.71.424-429

Cited by 12 publications

(15 citation statements)

References 16 publications

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“…To abate such condition, anaesthesiologists could apply several medications, such as beta-blockers, calcium channel blockers, lidocaine, propofol and opioids 4,11,[13][14][15][16][17] . Aside from diverse medications, different intubating skills and methods can reduce haemodynamic changes such as fiberoptic intubation 12,18 , optimal fentanyl dosage 4,9,19 and routes of drugs given 19 .…”

Section: Discussionmentioning

confidence: 99%

The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

Teong

Huang

Sun

2020

Sci Rep

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Endotracheal intubation elicits huge spectrum of stress responses which are hazardous in high-risk patients. Numerous drugs and techniques have been applied to attenuate the stress responses. In this double-blind study, one hundred and forty-five patients over 20 years old, ASA physical status I and II, undergoing elective surgeries requiring general anaesthesia with endotracheal intubation were included. Patients were randomly divided into three groups which fentanyl 2 mcg/kg was given at either 1, 2, 3 minutes before intubation. All groups received midazolam 0.05 mg/kg, lidocaine 0.5 mg/ kg, propofol 2 mg/kg and rocuronium 1 mg/kg before intubation. Haemodynamic parameters were recorded for 10 minutes after induction. Two-level longitudinal hierarchical linear models were used for data interpretation and P < 0.05 was considered statistically significant. The study demonstrated significantly lower haemodynamic responses in the group who received fentanyl 2 minutes before intubation (p < 0.05). Confounding factors such as smoking, hypertension, diabetes mellitus and preoperative intravenous fluid supplement were analysed. In conclusion, fentanyl injection 2 minutes before intubation is recommended in order to obtain the most stable haemodynamic status.

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Section: Discussionmentioning

confidence: 99%

The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

Teong

Huang

Sun

2020

Sci Rep

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“…14 In order to blunt the responses to endotracheal intubation, various drugs have been used such as lignocaine and opioids and non-narcotic analgesics. 2,3 An ideal drug should be easily administered, have a rapid onset of action, relatively short duration of action, and be safe. Ideal drugs include fentanyl and alfentanil but unfortunately these drugs areunavailable in most hospitals in Pakistan.…”

Section: Discussionmentioning

confidence: 99%

“…have been tried to prevent hemodynamic changes but each drug has its own limitations. 2,3 Opioids are important drugs in the management of attenuation of hemodynamic response during intubation. Use of opioids before induction of general anesthesia makes the intraoperative course smooth and decreases the intraoperative requirement of anesthetic agents.…”

Section: Introductionmentioning

confidence: 99%

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

Faridi¹,

Nasir²,

Haider³

et al. 2020

TPMJ

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Laryngoscopy and tracheal intubation causes sympathetic over activity in the form of increased heart rate and blood pressure, which may lead to deleterious effects. Opioid drugs like fentanyl and nalbuphine are routinely used to attenuate this response during intubation. A few studies have claimed that acetaminophen is efficacious for this purpose too. Various studies have explored its role in blunting of pressor response but none have compared it with nalbuphine. We compared these drugs with the purpose, if both drugs are equally effective; acetaminophen would be a better alternative to nalbuphine without adverse effects of an opioid. Objectives: The objective of this study was to compare the efficacy of acetaminophen and nalbuphine in attenuating hemodynamic response during tracheal intubation. Study Design: Randomized, double-blind clinical trial. Setting: Main operation theatre complex of Fauji Foundation Hospital Rawalpindi. Period: From August to December 2018. Material & Methods: After obtaining permission from institutional ethical review committee of Fauji Foundation Hospital Rawalpindi. 60 Patients of ASA physical status I and II, aged 30 to 55 years, undergoing abdominal surgical procedure of 1 to 3 hour duration were randomly divided into two groups. Patients in group N received nalbuphine hydrochloride 0.15 mg/kg body weight intravenously, 30 minutes before induction. Patients in group P received acetaminophen infusion (paracetamol) 15mg/kg body weight intravenously, 30 minutes before induction. Systolic and diastolic blood pressures were measured manually and heart rate by pulse oximeter. Observations were made before giving analgesics, during induction, 1 minute after intubation, then at every 1- minute intervals till first 5 minutes, and thereafter at 10 minutes and at 15 minutes after intubation. The descriptive statistics of data were expressed as mean and standard deviation. Independent samples t-test was used for comparison of mean values of the variables in both groups. The value of p< 0.05 was considered as statistically significant. Results: There was a significant rise in heart rate and blood pressure after laryngoscopy and endotracheal intubation with acetaminophen (P group) as compared to the N group in which nalbuphine effectively reduced the tachycardia and hypertension. Conclusion: Acetaminophen has no significant effect on the prevention of hemodynamic changes due to intubation. Nalbuphine effectively reduces tachycardia and hypertension associated with laryngoscopy and endotracheal intubation.

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“…Hemodynamic changes occur after direct laryngoscopy and further increase in heart rate and blood pressure occurs following endotracheal tube implantation [ 4 , 5 ]. To reduce hemodynamic alteration in direct laryngoscopy and intubation, the depth of anesthesia can be increased.…”

Section: Introductionmentioning

confidence: 99%

A prospective study on the incidence of sore throat after use of laryngeal mask airway during general anesthesia

Farazmehr

Aryafar

Gholami

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Laryngeal mask airway (LMA) is a useful alternative to intubation of the trachea to maintain the airways. The aim of this study was to evaluate the incidence of sore throat after LMA during general anesthesia in short-duration elective surgery. Method In this prospective study, 76 patients undergoing surgery with general anesthesia in (XXX) during 2018 and 2019 were selected and their demographic information were entered into the data collection form. Laryngeal mask airway was used in the subjects for airway maintenance during the surgery. The incidence of sore throat at postoperative 0, 6, 12 h was measured using Visual Analogues Scale (VAS) as primary outcome and it was then compared with demographic parameters as secondary outcomes. Result The mean age of the patient was 45.48 ± 14.89 years and 46 (60.5 %) of the patients were women. The mean BMI was 24.02 ± 3.05 kg/m 2 . The average duration of surgery was 56.9 ± 15.9 min. The incidence of sore throat immediately after the surgery and at 6 and 12 postoperative hours was 26.3 %, 23.7 %, and 19.7 %, respectively. The incidence of sore throat after the use of LMA was not significantly correlated with age, sex, and BMI (P > 0.05) Conclusions The findings of our study showed that pain due to sore throat following laryngeal mask airway was reported to be mild in our study. The postoperative sore throat may not associated with demographic variables.

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Hemodynamic Responses to Tracheal Intubation in Elderly Patients: Intravenous or Spray of Lidocaine versus Fentanyl

Cited by 12 publications

References 16 publications

The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

The Haemodynamic Response to Endotracheal Intubation at Different Time of Fentanyl Given During Induction: A Randomised Controlled Trial

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

A prospective study on the incidence of sore throat after use of laryngeal mask airway during general anesthesia

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