Chinese Med J Peking
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Chinese Med J Peking · Oct 2009
Randomized Controlled TrialPeri-intubation hemodynamic changes during low dose fentanyl, remifentanil and sufentanil combined with etomidate for anesthetic induction.
Although etomidate is associated with very few cardiovascular side-effects and minimal histamine release, it has a less inhibitory effect on the pharyngolaryngeal reflex. Hence, blunting the responses to endotracheal intubation is more dependent of opioids for etomidate-based anesthetic induction. This prospective, randomized, double-blinded study was designed to investigate the effects of low dose remifentanil, fentanyl or sufentanil on etomidate induction with respect to hemodynamics, conscious level changes and drug consumption. ⋯ In normotensive and unpremedicated young adult patients receiving etomidate induction, low dose remifentanil or sufentanil significantly reduced the time and the amount of etomidate taken to loss unconsciousness compared with low dose fentanyl, but similar time interval and doses of etomidate were required to acquire adequate depth of anesthesia (BIS = 50) for these three opioids. Remifentanil was more effective in blunting the cardiovascular responses to endotracheal intubation, nevertheless, accompanying significant lower heart rate after induction.