ABSTRACT
This study was performed on 40 adult patients to compare the efficacy of pretreatment with fentanyl or lidocaine IV. for supression of haemodynamic stress response in nasotracheal oriorotracheal fiberoptic intubation. Heart rate, mean arterial blood pressure, rate-pressure product showed significant decrease after fentanyl pretreatment which provided a good opportunity for successful a wake fiberoptic intubation inspite of minimal cardiovascular instability in the form of ventricular extrasystole in 3 patients. Also IV. lidocaine was effective in attenuating but not completely blocking cardiovascular response. In conclusion, fiberoptic intubation provided the better visualization of tissues and vocal cords; thus, decreasing the possibility of mechanical trauma but needs a good training program. Pretreatment with fentanyl and/or lidocaine should be used in an attempt to combat the cardiovascular responses during fiberoptic intubation, especially in patients in whom the pressor response to intubation is particularly hazardous