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Comparative evaluation of different doses of propofol preceded by fentanyl on intubating conditions and pressor response during tracheal intubation without muscle relaxants.
Paediatr Anaesth. 2006 Apr; 16(4):399-405.PA

Abstract

BACKGROUND

The aim of our study was to determine the optimal dose of propofol preceded by fentanyl for successful tracheal intubation and to see its effectiveness in blunting pressor response in children aged 3-10 years.

METHODS

This prospective, double blind, randomized study was conducted on 60 ASA grade I and II children, between 3 and 10 years undergoing elective surgery who were divided into three groups of 20 each. The children received different doses of propofol (group I, 2.5 mg x kg(-1); group II, 3.0 mg x kg(-1); group III, 3.5 mg x kg(-1)) preceded by a fixed dose of fentanyl (3.0 microg x kg(-1)) 3 min earlier. The tracheal intubating conditions were graded based on scoring system devised by Helbo-Hensen et al. with Steyn modification which includes five criteria; ease of laryngoscopy, degree of coughing, position of vocal cords, jaw relaxation, and limb movement and graded on a 4-point scale. Heart rate (HR), mean arterial pressure (MAP), and oxygen saturation changes were also noted.

RESULTS

Tracheal intubating conditions were acceptable in 25% of the patients in group I, while significantly higher (P < 0.001) in group II (80%) and in group III (90%). The pressor response was not effectively blunted in group I (17% increase in HR), while effectively blunted in groups II and III. A fall in cardiac output was seen in group III indicated by a decrease in MAP (16%) and HR (11%). No airway complications were noted.

CONCLUSIONS

Propofol 3 mg x kg(-1) (group II) preceded by fentanyl 3 microg x kg(-1) is the optimal dose combination in our study. It provides acceptable intubating conditions in 80% patients, blunts pressor response to intubation without significant cardiovascular depression.

Authors+Show Affiliations

Department of Anaesthesia, Safdarjang Hospital, Delhi, India. dr_akhi1@rediffmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16618293

Citation

Gupta, Akhilesh, et al. "Comparative Evaluation of Different Doses of Propofol Preceded By Fentanyl On Intubating Conditions and Pressor Response During Tracheal Intubation Without Muscle Relaxants." Paediatric Anaesthesia, vol. 16, no. 4, 2006, pp. 399-405.
Gupta A, Kaur R, Malhotra R, et al. Comparative evaluation of different doses of propofol preceded by fentanyl on intubating conditions and pressor response during tracheal intubation without muscle relaxants. Paediatr Anaesth. 2006;16(4):399-405.
Gupta, A., Kaur, R., Malhotra, R., & Kale, S. (2006). Comparative evaluation of different doses of propofol preceded by fentanyl on intubating conditions and pressor response during tracheal intubation without muscle relaxants. Paediatric Anaesthesia, 16(4), 399-405.
Gupta A, et al. Comparative Evaluation of Different Doses of Propofol Preceded By Fentanyl On Intubating Conditions and Pressor Response During Tracheal Intubation Without Muscle Relaxants. Paediatr Anaesth. 2006;16(4):399-405. PubMed PMID: 16618293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative evaluation of different doses of propofol preceded by fentanyl on intubating conditions and pressor response during tracheal intubation without muscle relaxants. AU - Gupta,Akhilesh, AU - Kaur,Ranvinder, AU - Malhotra,Rohit, AU - Kale,Suniti, PY - 2006/4/19/pubmed PY - 2006/9/9/medline PY - 2006/4/19/entrez SP - 399 EP - 405 JF - Paediatric anaesthesia JO - Paediatr Anaesth VL - 16 IS - 4 N2 - BACKGROUND: The aim of our study was to determine the optimal dose of propofol preceded by fentanyl for successful tracheal intubation and to see its effectiveness in blunting pressor response in children aged 3-10 years. METHODS: This prospective, double blind, randomized study was conducted on 60 ASA grade I and II children, between 3 and 10 years undergoing elective surgery who were divided into three groups of 20 each. The children received different doses of propofol (group I, 2.5 mg x kg(-1); group II, 3.0 mg x kg(-1); group III, 3.5 mg x kg(-1)) preceded by a fixed dose of fentanyl (3.0 microg x kg(-1)) 3 min earlier. The tracheal intubating conditions were graded based on scoring system devised by Helbo-Hensen et al. with Steyn modification which includes five criteria; ease of laryngoscopy, degree of coughing, position of vocal cords, jaw relaxation, and limb movement and graded on a 4-point scale. Heart rate (HR), mean arterial pressure (MAP), and oxygen saturation changes were also noted. RESULTS: Tracheal intubating conditions were acceptable in 25% of the patients in group I, while significantly higher (P < 0.001) in group II (80%) and in group III (90%). The pressor response was not effectively blunted in group I (17% increase in HR), while effectively blunted in groups II and III. A fall in cardiac output was seen in group III indicated by a decrease in MAP (16%) and HR (11%). No airway complications were noted. CONCLUSIONS: Propofol 3 mg x kg(-1) (group II) preceded by fentanyl 3 microg x kg(-1) is the optimal dose combination in our study. It provides acceptable intubating conditions in 80% patients, blunts pressor response to intubation without significant cardiovascular depression. SN - 1155-5645 UR - https://www.unboundmedicine.com/medline/citation/16618293/Comparative_evaluation_of_different_doses_of_propofol_preceded_by_fentanyl_on_intubating_conditions_and_pressor_response_during_tracheal_intubation_without_muscle_relaxants_ L2 - https://doi.org/10.1111/j.1460-9592.2005.01783.x DB - PRIME DP - Unbound Medicine ER -