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The effect of fentanyl on hemodynamic and bispectral index changes during anesthesia induction with propofol
Masayasu Nakayama1, Hiromichi Ichinose, Shuji Yamamoto
1Department of Anesthesiology, Obihiro Kosei Hospital, Japan. miyabi@zc4.so-net.ne.jp
Study Object:
To investigate the changes in hemodynamics and hypnotic levels during propofol infusion and tracheal intubation with and without fentanyl.
Design:
Randomized, double-blinded study.
Setting:
Teaching hospital.
Patients:
40 ASA physical status I adult patients scheduled for elective surgery.
Interventions:
Patients were anesthetized with either propofol (Group P; n = 20) or 2 microg/kg of fentanyl IV followed by propofol (Group PF; n = 20). Propofol was infused at 20 mg/kg/hr throughout the study, and tracheal intubation was performed 10 minutes after the start of propofol infusion.
Measurement And Main Results:
Bispectral index monitoring (BIS) progressively decreased to about 50 in both groups during infusion of propofol, but no difference was found between the two groups. After tracheal intubation, BIS significantly increased but remained below 60 in both groups. Hypertensive responses to intubation were fewer in Group PF than Group P.
Conclusions:
Propofol administration 20 mg/kg/hr for 10 minutes is suitable in suppressing arousal reactions to tracheal intubation, but the addition of fentanyl is required to blunt the hemodynamic responses.