Efficacy of Intravenous Fentanyl and Magnesium Sulfate in Attenuating Haemodynamic Response to Laryngoscopy and Endotracheal Intubation
Authors/Creators
- 1. Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore
- 2. Associate Professor, Department of Anaesthesiology, VTSM PCC, Kalaburgi
- 3. Consultant Cardiac Anaesthetist, Department of Anaesthesiology, Manipal hospital, Old Airport Road, Bangalore
Description
Introduction: Magnesium sulfate is cheap, readily available and widely used in obstetric practice with an established anaesthetic adjunct effect on hemodynamic parameters during anaesthesia and surgery. Narcotics have been extensively used for blunting the pressor response to endotracheal intubation. One of the most popular opioids used to attenuate this response is fentanyl. Aim: To compare the efficacy of fentanyl and magnesium sulfate in attenuating hemodynamic response during laryngoscopy and intubation. Methodology: A Comparative prospective randomized double blind study between two groups with 30 patients in Group F (Fentanyl) and 30 patients in Group M (MgSo4) was conducted. The study was conducted in the Department of Anaesthesiology at Bangalore Baptist Hospital, Bangalore. Results: There was insignificant rise in diastolic blood pressure in both groups after giving the study drug. Rise was strongly significant immediately after intubation and at 10th minute following intubation. Mean arterial pressure increased in both groups after intubation. Comparison of changes in mean arterial pressure across the groups indicated strong significance (P < 0.05) consistently following intubation till the end of study. Conclusion: It is possible that a combination of magnesium sulfate and fentanyl in lower doses may produce the benefits of both and is worthy of further studies and analysis.
Abstract (English)
Introduction: Magnesium sulfate is cheap, readily available and widely used in obstetric practice with an established anaesthetic adjunct effect on hemodynamic parameters during anaesthesia and surgery. Narcotics have been extensively used for blunting the pressor response to endotracheal intubation. One of the most popular opioids used to attenuate this response is fentanyl. Aim: To compare the efficacy of fentanyl and magnesium sulfate in attenuating hemodynamic response during laryngoscopy and intubation. Methodology: A Comparative prospective randomized double blind study between two groups with 30 patients in Group F (Fentanyl) and 30 patients in Group M (MgSo4) was conducted. The study was conducted in the Department of Anaesthesiology at Bangalore Baptist Hospital, Bangalore. Results: There was insignificant rise in diastolic blood pressure in both groups after giving the study drug. Rise was strongly significant immediately after intubation and at 10th minute following intubation. Mean arterial pressure increased in both groups after intubation. Comparison of changes in mean arterial pressure across the groups indicated strong significance (P < 0.05) consistently following intubation till the end of study. Conclusion: It is possible that a combination of magnesium sulfate and fentanyl in lower doses may produce the benefits of both and is worthy of further studies and analysis.
Files
IJPCR,Vol14,Issue7,Article43.pdf
Files
(130.4 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:82dc8c46cc1052f43e262dbc1212cafe
|
130.4 kB | Preview Download |
Additional details
Dates
- Accepted
-
2022-07-21
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue7,Article43.pdf
- Development Status
- Active
References
- 1. Bhardwaj N, Panda N, Kumar A. Pressor response to laryngoscopy and intubation – A Review. Journal of Anaesthesiology Clinical Pharmacology. 2003; 19 (3) : 237-249. 2. Prys Roberts C, Green LT, Meloche R, Foex P. Studies of anaesthesia in relation to hypertension II: Haemodynamic consequences of induction and endotracheal intubation. British Journal of Anaesthesia. 1971; 43: 531-46. 3. Takeshima K, Noda K, Higaki M. Cardiovascular response to rapid anesthesia induction and endotracheal intubation. Anesthesia Analgesia. 1987; 66 : 1036. 4. Misganaw A, Sitote M, Jernal S, Melese E, Hune M, Siyoum F, etal. Comparison of intravenous magnesium sulfate and lidocaine for attenuation of cardiovascular response to laryngoscopy and endotracheal intubation in elective surgical patients at Zewditu Memorial Hospital Addis Ababa, Ethiopia. 2021. PLOS ONE 16(6): e0252465. 5. Koinig H, Wallner T, Marhofer P, Andel H, Hörauf K, Mayer N. Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesthesia Analgesia. 1998; 87: 206– 10. 6. Neme Doba, Derartu, Ferede, Zemedu Aweke, Mola Kasa, Simeneh, Comparison of intravenous fentanyl versus lidocaine for attenuation of hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective surgery in Dilla University Referral Hospital, Ethiopia, a randomized controlled trial, International Journal of Surgery: Global Health: November 2020; 3(6):27. 7. Raviteja Vallabha DVKM Dr. Attenuating the Haemodynamic Stress to Laryngoscopy and Intubation with IV Magnesium Sulfate and Lignocaine. ISOR GDMS. 2018;17(4):19–27 8. Mendonça F T, Queiroz L M, Guimarães C C, Xavier A C. Effects of lidocaine and magnesium sulfate in attenuating hemodynamic response to tracheal intubation: single-center, prospective, double-blind, randomized study. Brazilian Journal of Anesthesiology (English Edition). 2017;67(1):50-6. 9. Panda NB, Bharti N, Prasad S. Minimal effective dose of magnesium sulfate for attenuation of intubation response in hypertensive patients. J Clin Anaesth. 2013 Mar;25(2):92-7. 10. Megalla S A, Abdou K A, Mohamed A I. Bispectralindex guided attenuation of hemodynamic and arousal response to endotracheal intubation using magnesium sulfate and fentanyl. Randomized, controlled trial. Egyptian Journal of anaesth. 2019;35 (1):43-8. 11. Kothari D, Mehrotra A, Choudary B, Mehra A. Effect of intravenous magnesium sulfate and fentanyl citrate on circulatory changes during anaesthesia and surgery: Aclinical study. Indian Journal of Anaesthesia. 2008; 52(6):800-804. 12. Puri GD, Marudhachalam KS, Pramila Chari, Suri RK. The effects of magnesium sulfate on haemodynamics and its efficacy in attenuating the response to endotracheal intubation in patients with coronary artery disease. Anesthesia Analgesia. 1998; 87:808- 11. 13. Kumar A, Seth A, Gogia A R. attenuation of the hemodynamic response to laryngoscopy and tracheal intubation with fentanyl, lignocaine nebulization and a combination of both: A randomized controlled trial. Anesthesia, essays and researches. 2016Sep-Dec;10(3):43-8.14. James MFM, Beer RE, Esser JD. Intravenous magnesium sulfate inhibits catecholamine release associated with tracheal intubation. Anesthesia Analgesia. 1989;68:772–776. 15. Allen RW, James MFM, Uys PC. Attenuation of pressor response to tracheal intubation in hypertensive proteinuric pregnant patients by lignocaine, alfentanil and magnesium sulfate. British Journal of Anaesthesia.1991; 66:216-223. 16. Helfman SM, Gold MI, DeLisser EA, Herrington CA. Which drug prevents tachycardia and hypertension associated with tracheal intubation : Lignocaine, Fentanyl or Esmolol ? Anaesthesia Analgesia. 1991; 72: 482– 486. 17. Chung F, Evans D. Low – dose fentanyl: haemodynamic response induction and intubation in geriatric patients. Can Anaesth Soc J. 1985; 32(6): 622-8. 18. Gupta K, Vohra V, Sood J. The role of magnesium as an adjuvant during general anaesthesia. Anaesthesia. 2006; 61(11):1058-63.