The Effects of the Lidocaine or Fentanyl Pretreatment on Inhalational Induction with Sevoflurane. |
Seung Hoon Baek, Joo Hyeuk Park, Chul Hong Kim, Jae Young Kwon, Hae Kyu Kim, Seong Wan Baik |
Department of Anesthesia and Pain Medicine, College of Medicine, Pusan National University, Busan, Korea. jykwon@pusan.ac.kr |
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Abstract |
BACKGROUND Sevoflurane has been widely used for inhalation induction and intubation in children and adults. There are some reports about hemodynamic instability and respiratory effects during inhalation induction. We evaluated the effects of fentanyl, lidocaine, or both on inhalation induction and intubation using sevoflurane without neuromuscular blocking agents. METHODS Forty healthy adult female patients, 20 to 60 years old, premedicated with midazolam 3 mg were randomly received iv saline (Group A), lidocaine 1 mg/kg (Group B), fentanyl 1microgram/kg (Group C) or both lidocaine 1 mg/kg and fentanyl 1microgram/kg (Group D). Anesthesia was induced with 8% sevoflurane inhalation and intubation was done without muscle relaxant. A blind observer recorded the change of blood pressure, heart rate, BIS score, and the time needed for induction and intubation. RESULTS The mean times for BIS score below 40 were 87 +/- 34 seconds and there were no significant difference among groups. The mean time for loss of self respiration and intubation in group A were significantly longer than those of other groups. The heart rates during induction and intubation of group A were significantly greater than those of other groups. There was no significant difference in blood pressure and side effects during intubation among groups. CONCLUSIONS Pre-treatment with fentanyl or lidocaine makes smoother and faster induction and intubation during vital capacity rapid inhalation induction with sevoflurane. |
Key Words:
endotracheal intubation; fentanyl; inhalation anesthesia; lidocaine; sevoflurane |
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