Hemodynamic impact of increasing time between fentanyl and propofol administration during anesthesia induction: a randomised, clinical trial.

Fentanyl General anesthesia Hemodynamics Intravenous anesthesia Propofol

Journal

Brazilian journal of anesthesiology (Elsevier)
ISSN: 2352-2291
Titre abrégé: Braz J Anesthesiol
Pays: Brazil
ID NLM: 101624623

Informations de publication

Date de publication:
26 Jul 2021
Historique:
received: 16 10 2020
revised: 25 06 2021
accepted: 10 07 2021
pubmed: 30 7 2021
medline: 30 7 2021
entrez: 29 7 2021
Statut: aheadofprint

Résumé

Anesthesia induction can produce severe propofol dose-dependent hypotension. Fentanyl coadministration reduces the catecholaminergic response to orotracheal intubation allowing propofol dose reduction. The aim of this study is to determine whether the hemodynamic response is improved by increasing the time between fentanyl and propofol administration and reducing the dose of the latter without increasing the time to achieve optimal hypnosis. After approval by the Research Ethics Committee, patients undergoing non-cardiac surgery with endotracheal intubation were randomized by a computer-generated table into six time-dose groups (1 or 2 minutes/1, 1.5, or 2 mg.kg Of the 192 recruited patients, 186 completed the study (1 min group n = 94; 2 min group n = 92). It was observed that HR and BP decreased after propofol administration and increased after intubation in all groups (p < 0.0001). In patients over 55 years, the 2 min - 2 mg.kg Increasing the time between the administration of fentanyl and propofol by up to two minutes results in greater hypotension in patients over 55 years.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Anesthesia induction can produce severe propofol dose-dependent hypotension. Fentanyl coadministration reduces the catecholaminergic response to orotracheal intubation allowing propofol dose reduction. The aim of this study is to determine whether the hemodynamic response is improved by increasing the time between fentanyl and propofol administration and reducing the dose of the latter without increasing the time to achieve optimal hypnosis.
METHODS METHODS
After approval by the Research Ethics Committee, patients undergoing non-cardiac surgery with endotracheal intubation were randomized by a computer-generated table into six time-dose groups (1 or 2 minutes/1, 1.5, or 2 mg.kg
RESULTS RESULTS
Of the 192 recruited patients, 186 completed the study (1 min group n = 94; 2 min group n = 92). It was observed that HR and BP decreased after propofol administration and increased after intubation in all groups (p < 0.0001). In patients over 55 years, the 2 min - 2 mg.kg
CONCLUSION CONCLUSIONS
Increasing the time between the administration of fentanyl and propofol by up to two minutes results in greater hypotension in patients over 55 years.

Identifiants

pubmed: 34324933
pii: S0104-0014(21)00290-6
doi: 10.1016/j.bjane.2021.07.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2021 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Auteurs

Paula A Vullo (PA)

Hospital Central de la Defensa Gómez Ulla-IMIDEF, Critical Care and Pain Unit, Department of Anesthesia, Madrid, Spain. Electronic address: agosvullo@hotmail.com.

María I Real Navacerrada (MI)

Hospital Universitario 12 de Octubre, Critical Care and Pain Unit, Department of Anesthesia, Madrid, Spain.

Ricardo Navarro Suay (R)

Hospital Central de la Defensa Gómez Ulla-IMIDEF, Critical Care and Pain Unit, Department of Anesthesia, Madrid, Spain.

Classifications MeSH