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Dexmedetomidine and Fentanyl in Endotracheal Intubation: A Comparative Analysis of Hemodynamic and Intubation Responses

Yıl 2024, Cilt: 6 Sayı: 1, 83 - 88, 31.01.2024
https://doi.org/10.37990/medr.1397044

Öz

Aim: Endotracheal intubation, a critical procedure in anaesthesia, can induce significant hemodynamic fluctuations, posing risks, especially to patients with cardiovascular concerns. This study compares the effects of dexmedetomidine and fentanyl, two agents commonly used to mitigate these responses, on endotracheal intubation conditions and associated hemodynamic changes.
Material and Method: Conducted at tertiary care training and research hospital, this study involved 60 patients aged 40-60, all classified American Society of Anesthesiologists (ASA) I-II, undergoing elective upper and lower extremity surgeries. Excluding patients with contraindicating conditions, the subjects were divided into two groups to receive either dexmedetomidine or fentanyl, along with propofol and vecuronium, for induction. Hemodynamic parameters were continuously monitored, and intubation conditions were assessed using the Cooper scoring system.
Results: The study found that both dexmedetomidine and fentanyl effectively stabilised hemodynamic parameters during intubation. However, the fentanyl group displayed significantly higher total scores on the Cooper intubation conditions scale, indicating more favourable conditions for endotracheal intubation in terms of ease and patient comfort.
Conclusion: While both dexmedetomidine and fentanyl are effective in maintaining hemodynamic stability during endotracheal intubation, fentanyl demonstrates a slight advantage in optimising intubation conditions. This distinction offers valuable insight for anesthesiologists in tailoring anaesthetic strategies and balancing patient safety with procedural efficiency in surgical settings.

Etik Beyan

Approval was received from the ethics committee of our hospital.

Destekleyen Kurum

No

Teşekkür

N/A

Kaynakça

  • Davis L, Cook-Sather SD, Schreiner MS. Lighted stylet tracheal intubation: a review. Anesth Analg. 2000;90:745-56.
  • Sneyd JR. Recent advances in intravenous anaesthesia. Br J Anaesth. 2004;93:725-36.
  • De Wolf AM, Fragen RJ, Avram MJ, et al. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg. 2001;93:1205-9.
  • Hsu YW, Cortinez LI, Robertson KM, et al. Dexmedetomidine pharmacodynamics: part I: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101:1066-76.
  • Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382-94.
  • Kreuer S, Schreiber JU, Bruhn J, Wilhelm W. Impact of patient age on propofol consumption during propofol-remifentanil anaesthesia. Eur J Anaesthesiol. 2005;22:123-8.
  • Aho M, Lehtinen AM, Erkola O, et al. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology. 1991;74:997-1002.
  • Saitoh N, Mikawa K, Kitamura S, et al. Effects of trimetaphan on the cardiovascular response to tracheal intubation Br J Anaesth. 1991;66:340-4. Erratum in: Br J Anaesth 1992;68:228.
  • Ozkose Z, Demir FS, Pampal K, Yardim S. Hemodynamic and anesthetic advantages of dexmedetomidine, an alpha 2-agonist, for surgery in prone position. Tohoku J Exp Med. 2006;210:153-60.
  • Dyck JB, Maze M, Haack C, et al. The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology. 1993;78:813-20.
  • Basar H, Akpinar S, Doganci N, et al. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters. J Clin Anesth. 2008;20:431-6.
  • Salihoglu Z, Demiroluk S, Demirkiran, Kose Y. Comparison of effects of remifentanil, alfentanil and fentanyl on cardiovascular responses to tracheal intubation in morbidly obese patients. Eur J Anaesthesiol. 2002;19:125-8.
  • Myles PS, Hunt JO, Fletcher H, et al. Remifentanil, fentanyl, and cardiac surgery: a double-blinded, randomized, controlled trial of costs and outcomes. Anesth Analg. 2002;95:805-12.
  • Uzümcügil F, Canbay O, Celebi N, et al. Comparison of dexmedetomidine-propofol vs. fentanyl-propofol for laryngeal mask insertion. Eur J Anaesthesiol. 2008;25:675-80.
Yıl 2024, Cilt: 6 Sayı: 1, 83 - 88, 31.01.2024
https://doi.org/10.37990/medr.1397044

Öz

Kaynakça

  • Davis L, Cook-Sather SD, Schreiner MS. Lighted stylet tracheal intubation: a review. Anesth Analg. 2000;90:745-56.
  • Sneyd JR. Recent advances in intravenous anaesthesia. Br J Anaesth. 2004;93:725-36.
  • De Wolf AM, Fragen RJ, Avram MJ, et al. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg. 2001;93:1205-9.
  • Hsu YW, Cortinez LI, Robertson KM, et al. Dexmedetomidine pharmacodynamics: part I: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101:1066-76.
  • Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382-94.
  • Kreuer S, Schreiber JU, Bruhn J, Wilhelm W. Impact of patient age on propofol consumption during propofol-remifentanil anaesthesia. Eur J Anaesthesiol. 2005;22:123-8.
  • Aho M, Lehtinen AM, Erkola O, et al. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology. 1991;74:997-1002.
  • Saitoh N, Mikawa K, Kitamura S, et al. Effects of trimetaphan on the cardiovascular response to tracheal intubation Br J Anaesth. 1991;66:340-4. Erratum in: Br J Anaesth 1992;68:228.
  • Ozkose Z, Demir FS, Pampal K, Yardim S. Hemodynamic and anesthetic advantages of dexmedetomidine, an alpha 2-agonist, for surgery in prone position. Tohoku J Exp Med. 2006;210:153-60.
  • Dyck JB, Maze M, Haack C, et al. The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology. 1993;78:813-20.
  • Basar H, Akpinar S, Doganci N, et al. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters. J Clin Anesth. 2008;20:431-6.
  • Salihoglu Z, Demiroluk S, Demirkiran, Kose Y. Comparison of effects of remifentanil, alfentanil and fentanyl on cardiovascular responses to tracheal intubation in morbidly obese patients. Eur J Anaesthesiol. 2002;19:125-8.
  • Myles PS, Hunt JO, Fletcher H, et al. Remifentanil, fentanyl, and cardiac surgery: a double-blinded, randomized, controlled trial of costs and outcomes. Anesth Analg. 2002;95:805-12.
  • Uzümcügil F, Canbay O, Celebi N, et al. Comparison of dexmedetomidine-propofol vs. fentanyl-propofol for laryngeal mask insertion. Eur J Anaesthesiol. 2008;25:675-80.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Anesteziyoloji
Bölüm Özgün Makaleler
Yazarlar

Ayşegül Torun Göktaş 0000-0001-9835-6635

Feriha Temizel Bu kişi benim 0000-0002-1617-9530

Gülten Arslan Bu kişi benim 0000-0002-8322-5357

Metin Özşeker Bu kişi benim 0000-0003-4144-4663

Hüsnü Süslü Bu kişi benim 0000-0001-8741-1619

Leyla Saitoğlu Bu kişi benim 0009-0001-6067-4010

Yayımlanma Tarihi 31 Ocak 2024
Gönderilme Tarihi 30 Kasım 2023
Kabul Tarihi 9 Ocak 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 6 Sayı: 1

Kaynak Göster

AMA Torun Göktaş A, Temizel F, Arslan G, Özşeker M, Süslü H, Saitoğlu L. Dexmedetomidine and Fentanyl in Endotracheal Intubation: A Comparative Analysis of Hemodynamic and Intubation Responses. Med Records. Ocak 2024;6(1):83-88. doi:10.37990/medr.1397044

 Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey

E-mail: medrecsjournal@gmail.com

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