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Related Experiment Video

Updated: Jan 20, 2026

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Pre-induction fentanyl dose-finding study for controlled hypotension during functional endoscopic sinus surgery.

Prabhat Choudhary1, Amitabh Dutta1, Nitin Sethi1

  • 1Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.

Indian Journal of Anaesthesia
|August 30, 2019
PubMed
Summary

Higher doses of pre-induction fentanyl (3 and 4 μg/kg) effectively facilitated controlled hypotension during functional endoscopic sinus surgery (FESS). These doses improved surgical conditions and surgeon satisfaction compared to lower doses.

Keywords:
Controlled hypotensionendoscopyfentanylparanasal sinusessurgery

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Area of Science:

  • Anesthesiology
  • Surgical Procedures
  • Pharmacology

Background:

  • Fentanyl's sympatholytic effect aids controlled intraoperative hypotension.
  • Functional endoscopic sinus surgery (FESS) can benefit from controlled hypotension.

Purpose of the Study:

  • Investigate the impact of varying pre-induction fentanyl doses on controlled hypotension during FESS.
  • Assess hemodynamic parameters, surgical field quality, and surgeon satisfaction.

Main Methods:

  • Prospective randomized study with 120 FESS patients.
  • Three groups received pre-induction fentanyl: 2 μg/kg, 3 μg/kg, or 4 μg/kg.
  • Primary outcome: intraoperative heart rate and mean arterial pressure.

Main Results:

  • Controlled hypotension achieved in all groups.
  • Higher fentanyl doses (3 & 4 μg/kg) led to significantly lower heart rates.
  • Superior surgical field conditions and surgeon satisfaction observed with 3 & 4 μg/kg fentanyl.
  • Reduced need for additional hypotensive agents (Trinitroglycerin, metoprolol) in higher dose groups.

Conclusions:

  • Pre-induction fentanyl at 3 μg/kg and 4 μg/kg offers superior controlled hypotension during FESS.
  • Higher doses improve hemodynamic control, surgical conditions, and surgeon satisfaction.
  • These doses reduce the requirement for supplementary hypotensive medications.