[Hemodynamic reaction in the ultrarapid induction and protection realized with fentanyl]

The hemodynamic response caused by the orthotracheal intubation and also the fentanyl-induced protection were determined in the patients with ultrarapid anesthetic induction. 60 patients were randomly distributed in 3 groups, each of 30 patients: group I, control, with sequential induction, group II, with ultrarapid induction, and group III with ultrarapid induction protected by fentanyl administration. In the patients in the groups II and III the hydrocortisone in the blood, taken 1 minute before induction and 3 minutes after intubation was dosed radioimmunologically. Measurement of the hemodynamic constants showed the increase of the systolic and diastolic AT, and of the pulse during laryngoscopy and in the first two minutes after intubation in all the patients investigated. The hemodynamic response was stronger in the lot with rapid induction, with important differences in comparison with the group with sequential induction. In the IIIrd group, the previous injection with fentanyl, 5 mcg/kg led to a less intense hemodynamic response to laryngoscopy and intubation, close to that of the control group. Likewise, the injection of the anesthetic was followed by an important decrease in the plasmatic hydrocortisone in comparison with the preinduction values.