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Year : 2010  |  Volume : 51  |  Issue : 1  |  Page : 18-22

Comparison of the relative efficacy of fentanyl premedication and repeat-dose propofol in attenuating the cardiovascular response to endotracheal intubation

1 Department of Anaesthesia, UNTH Enugu, Nigeria
2 Department of Anaesthesia, National Orthopaedic Hospital, Enugu, Nigeria

Correspondence Address:
A D Nwosu
Department of Anaesthesia, National Orthopaedic Hospital, Enugu
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Source of Support: None, Conflict of Interest: None

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Background: The cardiovascular response evoked by laryngoscopy and endotracheal intubation while causing no harm to majority of patients, could result in fatal consequences, or morbidity, in patients at risk. Objective: To evaluate the degree of cardiovascular response evoked by laryngoscopy and endotracheal intubation and compare the effectiveness of repeat-dose propofol and fentanyl premedication in attenuating this cardiovascular response. Methodology: A total of sixty-nine ( 69) patients participated in this double-blind, randomized, prospective study. The change in the cardiovascular parameters following endotracheal intubation were evaluated in three groups of patients; Control(Untreated), Repeat-dose propofol and Fentanyl groups. The parameters considered were Heart rate (HR), Systolic arterial pressure (SAP), Diastolic arterial pressure (DAP),Mean arterial pressure (MAP) and Rate-pressure product (RPP). Results: The untreated group had increase in HR ( 36. 4%), SAP ( 42. 3%), DAP ( 36. 5%), MAP ( 39. 3%), RPP ( 94. 2%) following laryngoscopy and intubation. The fentanyl group had minimal increase in HR ( 11. 6%), SAP ( 11. 64%), DAP ( 11. 42%), MAP ( 11. 35%), RPP ( 24. 6%). Similarly the repeat-dose propofol group had minimal increase in HR ( 13. 6%), SAP ( 16. 63%), DAP ( 19. 5%), MAP ( 17. 2%), RPP ( 32. 8%). Conclusion: Endotracheal intubation in the untreated group was associated with remarkable increases in all the measured cardiovascular parameters whereas patients in the fentanyl group and repeat-dose propofol groups had significantly less increases in the parameters.

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