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Estrategias de inducción para prevenir cambios hemodinámicos después de la intubación en pacientes no sometidos a
Yunfan Gan1, Xiaoling Yang1, Weiliao Wang1
1Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Frontiers in medicine
|February 9, 2026
Resumen
Oxycodone-Propofol-Lidocaine mejor controlado fluctuaciones de la presión arterial después de la intubación traqueal. Fentanyl-Propofol-Dexmedetomidine fue superior para el control de la frecuencia cardíaca en pacientes sin cirugía cardíaca.
Área de la Ciencia:
- Anestesiología Anestesiología.
- Farmacología Farmacología.
- Fisiología cardiovascular fisiología cardiovascular.
Sus antecedentes:
- La intubación traqueal y la laringoscopia durante la anestesia general causan cambios hemodinámicos significativos.
- Estos cambios fisiológicos pueden conducir a eventos cardiovasculares críticos en pacientes de alto riesgo.
- Los anestesiólogos utilizan combinaciones de fármacos para mitigar estas respuestas.
Objetivo del estudio:
- Identificar la combinación óptima de fármacos para suprimir las fluctuaciones hemodinámicas durante la intubación traqueal en cirugía no cardíaca.
- Para comparar la eficacia de varias estrategias farmacológicas en el manejo de la hemodinámica intraoperatoria.
Principales métodos:
- Se realizó un metanálisis en red (NMA) de ensayos controlados aleatorios (ECA) de tres bases de datos de literatura médica.
- Los ECA se evaluaron para el riesgo de sesgo utilizando la herramienta Cochrane.
- El estudio comparó los efectos de diferentes combinaciones de medicamentos en la presión arterial media (ΔMAP) y la frecuencia cardíaca (ΔHR).
Principales resultados:
- La NMA incluyó 10 estudios con 791 pacientes.
- La oxicodona-propofol-lidocaína demostró una eficacia superior en el control de las fluctuaciones de la MAP (87,4%).
- Fentanyl-Propofol-Dexmedetomidine mostró una eficacia superior en el control de las fluctuaciones de la HR (94,8%).
Conclusiones:
- Se recomienda la oxicodona-propofol-lidocaína para atenuar los cambios en la MAP después de la incubación.
- Fentanyl-Propofol-Dexmedetomidine ofrece un control superior de las fluctuaciones de la HR.
- Se necesitan más ECA para confirmar los hallazgos y optimizar la dosificación del fármaco.
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