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Anesthetic induction with fentanyl.

P L Bailey, J Wilbrink, P Zwanikken

    Anesthesia and Analgesia
    |January 1, 1985
    PubMed
    Summary
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    Fentanyl at 30 mcg/kg is not a reliable anesthetic induction dose for patients under 60. Age and premedication, particularly diazepam and pancuronium, significantly enhance fentanyl

    Area of Science:

    • Anesthesiology
    • Pharmacology

    Background:

    • Fentanyl is a potent opioid analgesic used in anesthesia.
    • Anesthetic induction agents require careful dose titration for efficacy and safety.

    Purpose of the Study:

    • To evaluate fentanyl (30 mcg/kg) as an anesthetic induction agent.
    • To assess the impact of pancuronium and diazepam premedication on fentanyl's efficacy and side effects.
    • To document loss of consciousness, recall, rigidity, muscle movements, and hemodynamic changes.

    Main Methods:

    • Seventy-two ASA I-III patients undergoing 2-4 hour operations were studied.
    • Patients received fentanyl (30 mcg/kg) for anesthetic induction.
    • Preinduction treatments included pancuronium and/or diazepam.

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    Main Results:

    • 74% of patients achieved anesthesia with fentanyl.
    • Diazepam enhanced induction success, while pancuronium reduced rigidity.
    • Age correlated positively with unconsciousness and rigidity; patients over 60 were all anesthetized.
    • Diazepam decreased heart rate and blood pressure; 17 patients needed reversal of narcotic effect.

    Conclusions:

    • Fentanyl 30 mcg/kg is unreliable for anesthetic induction in patients under 60.
    • Patient age and premedication significantly influence fentanyl's anesthetic effectiveness.
    • Pancuronium and diazepam can mitigate fentanyl-induced rigidity and hemodynamic changes, respectively.