Effect of Varying Time Interval between Fentanyl and Propofol Administration, On Propofol Requirement for Induction of Anaesthesia
- 1. Postgraduate 3rd Year, Department of Anaesthesiology and Critical Care, Sri Siddhartha Medical College and Research Institute, Tumkur, Karnataka, India
- 2. Professor, Department of Anaesthesiology and Critical Care, Sri Siddhartha Medical College and Research Institute, Tumkur, Karnataka, India
- 3. Professor and Head, Department of Anaesthesiology and Critical Care, Sri Siddhartha Medical College and Research Institute, Tumkur, Karnataka, India
Description
Introduction: Fentanyl synergistically enhances propofol effects and reduces hemodynamic response during induction. Fentanyl and propofol administration timing affects propofol dose and associated side effects. Aim and Objectives: Primary objective is to calculate the total dose of propofol required to achieve loss of consciousness during induction of anesthesia. Secondary objective is to examine the Incidence of hypotension during induction and to examine any Incidence of any movement or Bucking or Any vocalization after initial dose of propofol. Materials & Methods: After institutional ethical clearance, 68 ASA status I & II patients, aged 18-65 years, undergoing elective surgery under general anesthesia were randomized into two groups; Fentanyl 2 mcg/kg was administered immediately prior to, 5 and 7 min before induction with propofol in Groups A and B, respectively. The requirement of propofol induction dose and hemodynamic parameters was recorded. Statistical analysis was performed using software SPSS, P-value <0.05 was considered statistically significant. Results: Demographic characteristics were comparable in both the groups. Total dose of propofol required for induction was higher in Groups A than group B (Group A vs. 85.88±14.221mg vs. 56.52±12.530 mg). Incidence of movement, vocalization, bucking is higher in Group A than Group B (P=<0.000001, P=0.002, P=0.007 respectively). Incidence of hypotension during induction was significantly lower in Group B (5.9%) than Group A (94.1%; P =<0.00001). Conclusion: Administering fentanyl 7 min prior to propofol causes marked reduction in the dose requirement of the propofol along with a significantly decreased incidence of hypotension during induction.
Abstract (English)
Introduction: Fentanyl synergistically enhances propofol effects and reduces hemodynamic response during induction. Fentanyl and propofol administration timing affects propofol dose and associated side effects. Aim and Objectives: Primary objective is to calculate the total dose of propofol required to achieve loss of consciousness during induction of anesthesia. Secondary objective is to examine the Incidence of hypotension during induction and to examine any Incidence of any movement or Bucking or Any vocalization after initial dose of propofol. Materials & Methods: After institutional ethical clearance, 68 ASA status I & II patients, aged 18-65 years, undergoing elective surgery under general anesthesia were randomized into two groups; Fentanyl 2 mcg/kg was administered immediately prior to, 5 and 7 min before induction with propofol in Groups A and B, respectively. The requirement of propofol induction dose and hemodynamic parameters was recorded. Statistical analysis was performed using software SPSS, P-value <0.05 was considered statistically significant. Results: Demographic characteristics were comparable in both the groups. Total dose of propofol required for induction was higher in Groups A than group B (Group A vs. 85.88±14.221mg vs. 56.52±12.530 mg). Incidence of movement, vocalization, bucking is higher in Group A than Group B (P=<0.000001, P=0.002, P=0.007 respectively). Incidence of hypotension during induction was significantly lower in Group B (5.9%) than Group A (94.1%; P =<0.00001). Conclusion: Administering fentanyl 7 min prior to propofol causes marked reduction in the dose requirement of the propofol along with a significantly decreased incidence of hypotension during induction.
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IJPCR,Vol16,Issue8,Article158.pdf
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Additional details
Dates
- Accepted
-
2024-07-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue8,Article158.pdf
- Development Status
- Active
References
- 1. Egan TD, Shafer SL. Target-controlled infusions for intravenous anesthetics: surfing thepopulation curves. Anesthesiology. 2003; 99(5):1035-7. 2. Reves JG, Glass PSA, Lubarsky DA, et al. Intravenous anesthetics. In: Miller RD, editor. Miller's Anesthesia. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 317- 78. 3. Gavrin JR. Anesthesia and Postoperative Pain Control. Fractures in the Elderly: A Guide to Practical Management. 2011:115-43. 4. Kazama T, Ikeda K, Morita K, et al. Reduction by fentanyl of the Cp50 of propofol for loss of consciousness and skin incision. Anesthesiology. 1997; 87(2):213-7. 5. Sebel PS, Lowdon JD. Propofol: a new intravenous anesthetic. Anesthesiology. 1989; 71(2):260-77. 6. Hannallah M, Carroll J, Charabaty A, Palese C, Barton F, Haddad N. Comparison of propofol versus propofol/fentanyl anesthesia. Anaesthesia, Pain & Intensive Care. 2018:161- 4. 7. Doze VA, Westphal LM, White PF. Comparison of propofol with methohexital for outpatient anesthesia. Anesth Analg. 1986; 65(11):1189-95. 8. Darlong V, Som A, Baidya D, Pandey R, Punj J, Pande A. Effect of varying time intervals between fentanyl and propofol administration on propofol requirement for induction of anaesthesia: Randomised controlled trial. Indian J Anaesth. 2019; 63:827-33. 9. Vullo PA, NavacerradaMarÍIR, Suay RN. Hemodynamic impact of increasing time between fentanyl and propofol administration during anesthesia induction: a randomised, clinical trial. Brazilian Journal of Anesthesiology/Brazilian Journal of Anesthesiology2024; 74:744230. 10. Ganesh V, Luthra A, Amburu V, Naik BN, Singh A, Puri GD. Low-Dose Dexmedetomidine Reduces Median Effective Concentration (EC 50) of Propofol More than Fentanyl in Unparalysed Anaesthetised Patients for I-gel Insertion: a Randomised Controlled Trial. Anaesthesia Critical Care & Pain Medicine 2021; 40:100815. 11. Hayakawa-Fujii Y, Takada M, Ohta S, Dohi S. Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanylketamine. Journal of Anesthesia2001; 15:191– 6. 12. Shetabi H, Adinehmehr L, Faezeh S. The effect of remifentanil on hemodynamic response to laryngeal mask airway insertion in induction of anesthesia with propofol fentanyl or propofol ketamine in cataract surgery. Majallah-iPizishkī-iDānishgāh-i ̒Ulūm-iPizishkīiTabrīz2022; 44:210–20. 13. Eldemrdash AM, Al-Azhary MAM. A Comparative Study of Uses of Ephedrine by Different Doses on Prevention of Hemodynamic Changes Accompanied with Induction of General Anesthesia through Propofol and Fentanyl without Adverse Effects. Open Journal of Anesthesiology2017; 07:341–50. 14. Joshi GP, Kamali A, Meng J, Rosero E, Gasanova I. Effects of fentanyl administration before induction of anesthesia and placement of the Laryngeal Mask Airway: a randomized, placebo-controlled trial. Journal of Clinical Anesthesia2014; 26:136–42. 15. Smith C, McEwan AI, Jhaveri R, Wilkinson M, Goodman D, Smith LR, et al. The Interaction of Fentanyl on the Cp50 of Propofol for Loss of Consciousness and Skin Incision. Anesthesiology1994; 81:820–8. 16. Ghabash M, Matta M, Kehhaleh J. Depression of excitatory effects of propofol induction by fentanyl. PubMed 1996; 13:419–25.