Fentanyl Versus Lidocaine Intravenously to Attenuate Hemodynamic Effects of En-dotracheal Intubation

Abstract

Background and objectives: Hemodynamic changes to laryngoscopy and endotracheal intubation may increase morbidity in the perioperative period. Those changes may become significant in patients with uncontrolled hypertension or heart diseases. In this study, we compared the efficacy of intravenous fentanyl and intravenous lidocaine in attenuating the hemodynamic responses during laryngoscopy and intubation. Methods: A total of 100 adult patients, American Society of Anesthesiologists physical status I and II from both gender aged 18 to 65 years undergoing various elective surgeries under general anesthesia, were included in this prospective, randomized, single-blind study. The patients were randomly divided into two equal groups, Group F received 1mcg/kg fentanyl IV 3 minutes before intubation, group L received 1mg/kg lidocaine IV 3 minutes before intubation. Patients in both groups were anesthetized with the same technique. heart rate, systolic, diastolic and mean blood pressure were monitored and recorded before giving the study drug, 3 minutes after giving the study drug, 3 minutes after intubation then 6 minutes after intubation. Results: We evaluated 100 patients including 49 males and 51 females, 62 American Society of Anesthesiologists physical status I and 38 American Society of Anesthesiologists physical status II, there were significant differences between the two groups 3 and 6 minutes after intubation, F group had less rise in heart rate, systolic, diastolic and mean blood pressure than L group 3 minutes after induction and endotracheal intubation. Conclusions: we concluded that fentanyl 1mcg/ kg IV had more and faster effect in blunting stress response to laryngoscopy and endotracheal intubation as compared to lidocaine 1mg/kg IV.