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Canadian Journal of Anesthesia, Vol 32, 622-628, Copyright © 1985 by Canadian Anesthesiologists' Society

Low-Dose Fentanyl: Haemodynamic Response During Induction and Intubation in Geriatric Patients

FRANCES CHUNG MD FRCPC1 and DAVID EVANS MD FRCPC1

1 Department of Anaesthesia, University of Toronto, Toronto Western Hospital, Toronto, Ontario

Address correspondence to: Dr F. Chung, Dept. of Anaesthesia, Toronto Western Hospital, 399 Bathurst St., Toronto, Ontario, Canada, M5T 2S8.

Twenty-eight surgical patients aged 65-84 were randomly assigned to either a control group (12) induced with thiopentone alone, or a treatment group (16), induced with 3 µg·kg-1 fentanyl followed by thiopentone, to determine whether the use of fentanyl during induction would attenuate the cardiovascular response to laryngoscopy and intubation.

Patients in the fentanyl group required 47 per cent less thiopentone for induction. Increases in systolic(SBP) and diastolic(DBP) blood pressure were significantly smaller in the group receiving fentanyl at one minute post intubation. SBP rose by 56 mmHg in the control group, compared to 15 mmHg in the fentanyl group; DBP increased 42 mmHg compared to 20 mmHg, respectively. Increases in rate-pressure product were twice as great in the control group compared to the fentanyl group (72.2 vs 36.0 per cent, respectively).

Thus, fentanyl, as an adjunct to barbiturate induction, effectively lowered the thiopentone requirement and attenuated the pressor response to laryngoscopy and intubation.

Key Words: ANALGESICS: fentanyl • INTUBATION, ENDOTRACHEAL: cardiovascular responses • AGE FACTORS






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Copyright © 1985 by the Canadian Anesthesiologists' Society.