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Showing 4 results for Fentanyl

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Volume 4, Issue 1 (4-2004)

  Background & Objective: Spinal anesthesia is one of the usual techniques in the surgery of hip fractures among the aged. On the other hand the hemodynamic complications of this method and the treatment of these complications by abundant Ir liquids and drugs such as Ephedrin and phenylephedrin have potential risk for aged patients. Intrathecal opioids have synergistic effects on the duration and quality of spinal block. Thus a number of efforts have been made to prevent the hemodynamic complications and probability of inadequate block by decreasing the dosage of local anesthetic drug and adding opioid drugs to it. This study investigates the hemodynamic effects and the quality of spinal anesthesia using the above-mentioned method.

  Methods: Forty-six patients above 60 years of age with hip fracture were randomized into 2 groups (A and B). Group A received a spinal of hyper tonic bupivacaine (5 mg) and fentanyl (20 m g) and group B received 12.5 mg of hypertonic bupivacaine for spinal anesthesia. Vital signs before and during the surgery, quality and quantity of blockage, amount of fluid and Ephedrine used, were recorded every 5 minutes.

  Results: MAP (Mean Arterial Pressure) fall and the dosage and frequency of ephedrine consumption were significantly different in two groups. MAP decrease in-group A was 23.6 ± 10.79 and in-group B it was 36 ± 11.1 (p=0.001). The average requirement of ephedrine in the groups were 2.25 ± 3.49 mg in-group A and 10 ± 8.45 mg in-group B (P=0.001). The average occurrence of hypotension and ephedrine usage was 0.71 ± 1.08 times in-group A and 2.91 ± 2.94 times in-group B (p=0.001). 29 % of group A had pain in the terminal stage of surgery but this amount in-group B was 13.6%. Tachycardia was 29.2 % in-group A and 68.2 % in group B (p=0.001).

  Conclusions: Adding 20 m g fentanyl to bupivacaine and decreasing its dosage can prevent the complications of intrathecal anesthesia. (MAP fall and the tachycardia occurred in the process of its treatment) to a great extent. But to lower the incidence of failure and obtain reliable block, more controlled studies must be accomplished.

Ghodrat Akhavan Akbary , Abdolrasool Heidari , Shokouh Sadr Azodi ,
Volume 4, Issue 3 (9-2004)

  Background & Objectives : Laryngoscopy and tracheal intubation may lead to tachycardia, hypertension and dysrhythmia or myocardial ischemia. In this double blind study, the effects of midazolam and lidocaine on hemodynamic response to endotracheal intubation have been examined.

  Methods : 52 ASA class one patients, aged 20-50, who were candidate for elective inguinal hernia surgery with general anesthesia, were randomly assigned to two groups. All patients received normal saline or Ringer's lactate solution (5ml/kg) about 5-10 minutes before induction of anesthesia and were preoxygenated for 3 minutes. Group 1 received midazolam (0.05 mg/kg) and group 2 received lidocaine (1.5 mg/kg) during 3 minutes prior to intubation. Anesthesia was induced with fentanyl (100 µ g) and thiopental (5 mg/kg) and trachea was intubated by the aid of succinyl choline (1.5 mg/kg). Anesthesia was maintained with halothane (0.5-0.75%) and equal proportions of nitrous oxide and oxygen. Systolic and diastolic blood pressure, mean arterial pressure (MAP) and heart rate were recorded before premedication and intubation, as well as immediately two and five minutes after intubation. The data were analyzed by SPSS software using paired t-test.

  Results : After intubationSystolic and diastolic blood pressure, MAP and heart rate increased in both groups compared to the baseline values. The difference in increasing diastolic blood pressure and MAP between the two groups was significant (p<0.05), but the difference in increasing systolic blood pressure and heart rate between two groups was not statistically significant. The increase in diastolic blood pressure and MAP in group 1 was significantly more than group 2 (p<0.05).

  Conclusion : Clinically, midazolam was as much effective as lidocaine in controlling response to intubations. Consequently it can be used as an alternative lidocaine in intubations. It has also other priorities such as amnesia, anti-anxiety and anti-agitation.

Simin Atash Khoii , Mehri Jafari Shobayri , Sohrab Negargar ,
Volume 5, Issue 1 (4-2005)

 Background and Objectives: Pre-eclampsia is one of the common causes of maternal mortality. A main problem with induction of general anesthesia in these patients is exagergted increase of blood presscure during laryngoscopy and intubation that is associateed with a significantly increased intracranial pressure with the risk of cerebral hemorrhage. There are some strategies to minimize extreme increase in blood pressure during laryngoscopy and intubation. The aim of this study was to evaluate the effect of Fentanyl-Droperidol combination (Talamonal) on reducing cardiovascular responses due to laryngoscopy and intubation in preeclamptic parturient.

 Methods: Thirty preeclamptic parturients who were admitted for emergency caesarean section under general anesthesia were studied. All patients had diastolic pressures sustained at ≥ 100 mmHg, and had received antihypertensive therapy. A standard general anesthesia was induced in all patients. Fentanyl-Droperidol combination was used only in the case group five minutes before induction of anesthesia.

 Results: Arterial pressure and heart rate increases, improved in approximately 86.6 % of the case group. The mean increase in systolic pressure, and heart rate following laryngoscopy and intubation was significantly different in two groups (P=0.0001). There was no significant difference in the mean Apgar score of the neonates at 1 and 5 minutes after delivery in two groups.

 Conclusion: Using Fentanyl-Droperidol Combination during induction of anesthesia produced a clinically significant decrease in sympathetic response to laryngoscopy and intubation in most mothers, without any adverse effect on the neonates.

Simin Atashkhoii, Rasool Azarfarin , Zahra Fardiazar ,
Volume 7, Issue 3 (9-2007)

  Background & Objectives: A common side effect associated with succinylcoline is postoperative myalgia. The pathogenesis of this myalgia is still unclear therefore there is no ideal method of decreasing the rate and severity of fasciculation and postoperative myalgia. The aim of this prospective and randomized study was to evaluate the influence of low-dose succinylcholine for tracheal intubation on the rate and severity of fasciculation and postoperative myalgia.

  Methods: In this study, 60 patients of ASA physical grading I or II were randomly entered into two groups of 30 patients each. One fasciculation was evaluated on the basis of Mingus and myalgia on the basis of Harvey Induction of anesthesia was performed with fentanyl/thiopentone, and then succinylcholine 1 mg/kg (control group) and 0.6 mg/kg (case group) were administered to patients for tracheal intubation.

  Results: There was not fasciculation in 50% (15 patients) of study group and on the rest no severe fasciculation occurred. Furthermore, the severity of fasciculation in the study group was significantly lower than that of control group (p<0.0001). In 16 (53.3%) patients of study group and 4 (13.3%) of control group myalgia were not occurred. Severity of myalgia was also significantly lower in study group than the control group (p<0.0001). Acceptable intubating conditions in all patients of two groups.

  Conclusion: Decreasing the dose of succinylcholine (from 1 mg/kg to 0.6 mg/kg) both provides acceptable intubation conditions, and reduces the rate and intensity of succinylcholine induced fasciculation and postoperative myalgia.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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