The Effects of Fentanyl Preloading on the Hemodynamic Responses to Endotracheal Intubation / 대한마취과학회지

ABSTRACT

The effects of fentanyl, used as preloading drug to thiopental for induction of anesthesia, on the hemodynamic responses to endotracheal intubation were investigated in 60 surgical patients. Normotensive patients were randomly assigned to receive thiopental 5 mg/kg alone(N = 20, group A) or fentanyl 3 mcg/kg preloading 4 minutes before thiopental 3 mg/kg(N=20, group B) for induction of anesthesia. Hypertensive patients(N=20, group C) reeeived the same as group B. Electrocardiogram(EKG), mean arterial pressure(MAP), heart rate(HR), and rate-pressure product(RPP) were measured automatically before and during induction of anesthesia and after endotracheal intubation. The incidence of tachycardia were 20% in normotensive group and 25% in group C. Premature ventricular contracture or ST segment depression were appeared in 25% of patients in group C. Following intubation MAP, HR and RPP were all increased significantly but the change of them were more greater in group A than other groups. We concluded that blunting effects of the low dose fentanyl preloading used before thiopental induction to postintubation hypertension and tachycardia were statistically signifieant in normo-and hypertensive patients. But in clinical view, hypertensive patients should be managed more carefully. And further investigation seems warranted for the evaluation of preloading fentanyl dosage or combination of antihypertensive drugs and fentanyl.