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Korean J Anesthesiol > Volume 29(3); 1995 > Article
Korean Journal of Anesthesiology 1995;29(3):358-363.
DOI: https://doi.org/10.4097/kjae.1995.29.3.358   
Blood Pressure and Heart Rate Changes and the Patient Response following I.V. Administration of Fentanyl during Awake Fiberoptic Nasotracheal Intubation.
Dae Hyun Jo, Byeong Geon Lee, Kun Woo Lee, Ki Chul Kang, Kwang Won Yum
1Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
2Department of Anesthesiology, College of Dentistry, Seoul National University, Seoul, Korea.
Abstract
The purpose of this prospective study was to evaluate the patient response and the changes of blood pressure and heart rate following intravenous administration of various dosage of fentanyl during awake fiberoptic nasotracheal intubation. After verbal informed consent, the 44 ASA status I or II patients undergoing oral and maxillofacial surgery were randomly assigned to receive 0(N=11), 1(N=11), 2(N=11), 3(N=l1) ug/kg of fentanyl, On arrival to operating room, midazolam 2 mg and glycopyrrolate 0.2 mg were administered for premedication. And then, EKG, blood pressure and peripheral O2 saturation were monitored continuously. Local anesthesia was induced with the gargling of 4% lidocaine 10ml, the transtracheal injection of 4% lidocaine 3ml and nasal spray 10% lidocaine 0.5ml. After that each dose of fentanyl was given to each groups. And then fiberoptic intubation was performed with continuous verbal contact to confirm the patient response and ventilatory status during intubation. During fiberoptic intubation, the peak level of blood pressure and heart rate were recorded. We compare the difference of blood pressure and heart rate between the value of just before fiberoptic intubation and the peak value during fiberoptic intubation and discomfort score according to fentanyl dosage on the first day of postoperation. The change of blood pressure and the time required for intubation was less and shortest in the 2 ug/kg of fentanyl group. But there were no significant differences in heart rate and discomfort score. We conclude that 2 ug/kg of fentanyl minimize the change of blood pressure as well as intubation time. But the change of dosage of fentanyl was not helpful to decrease the discomfort score.
Key Words: Awake fiberoptic bronchoscopic intubation; Fentanyl; Discomfort score


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