E Freye1, J V Levy. 1. Heinrich-Heine-University of Düsseldorf, Clinics of Vascular Surgery and Renal Transplantation, Düsseldorf, Germany. enno.freye@uni-duesseldorf.de
Abstract
BACKGROUND AND OBJECTIVE: To evaluate the different potencies of several opioids in obtunding reflex mechanisms of laryngoscopy and intubation. METHODS: Three groups of patients (each n = 25, ASA 1-2) undergoing elective plastic surgery were randomly given meptazinol (2.5 mg kg-1), nalbuphine (0.3 mg kg-1) or fentanyl (5 microg kg-1) in a blinded fashion prior to laryngoscopy and intubation. This was followed by a standardized bolus induction of a barbiturate and a muscle relaxant. The response to laryngoscopy and intubation was studied, using blood pressure, heart rate and bispectral index. RESULTS: With fentanyl, there was an increase of heart rate by 17%, and systolic blood pressure by 7% when compared to control. Bispectral index dropped an additional 8% when compared to 1 min after barbiturate induction. In the nalbuphine group there was a 16% increase in systolic blood pressure, and a 16% increase in heart rate when compared to control. Also, bispectral index increased by 18% when compared to 1 min after barbiturate injection. The group receiving meptazinol demonstrated no cardiovascular changes although bispectral index dropped by an additional 19% when compared to 1 min after barbiturate injection. CONCLUSION:Meptazinol, appears to depress cardiovascular stimulatory effects and electroencephalogram arousal induced by laryngoscopy and intubation better than nalbuphine or fentanyl.
RCT Entities:
BACKGROUND AND OBJECTIVE: To evaluate the different potencies of several opioids in obtunding reflex mechanisms of laryngoscopy and intubation. METHODS: Three groups of patients (each n = 25, ASA 1-2) undergoing elective plastic surgery were randomly given meptazinol (2.5 mg kg-1), nalbuphine (0.3 mg kg-1) or fentanyl (5 microg kg-1) in a blinded fashion prior to laryngoscopy and intubation. This was followed by a standardized bolus induction of a barbiturate and a muscle relaxant. The response to laryngoscopy and intubation was studied, using blood pressure, heart rate and bispectral index. RESULTS: With fentanyl, there was an increase of heart rate by 17%, and systolic blood pressure by 7% when compared to control. Bispectral index dropped an additional 8% when compared to 1 min after barbiturate induction. In the nalbuphine group there was a 16% increase in systolic blood pressure, and a 16% increase in heart rate when compared to control. Also, bispectral index increased by 18% when compared to 1 min after barbiturate injection. The group receiving meptazinol demonstrated no cardiovascular changes although bispectral index dropped by an additional 19% when compared to 1 min after barbiturate injection. CONCLUSION:Meptazinol, appears to depress cardiovascular stimulatory effects and electroencephalogram arousal induced by laryngoscopy and intubation better than nalbuphine or fentanyl.
Authors: Ali Kord Valeshabad; Omid Nabavian; Keramat Nourijelyani; Hadi Kord; Hossein Vafainejad; Reza Kord Valeshabad; Ali Reza Feili; Mehdi Rezaei; Hamed Darabi; Mohammad Koohkan; Poorya Golbinimofrad; Samira Jafari Journal: Anesthesiol Res Pract Date: 2014-04-13