British Journal of Anaesthesia, Vol 82, Issue 4 561-565, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. Katoh, Y. Nakajima, G. Moriwaki, S. Kobayashi, A. Suzuki, T. Iwamoto, H. Bito and K. Ikeda
We studied 80 healthy ASA 1 patients (aged 20-52 yr) to determine if
fentanyl affects sevoflurane requirements for achieving 50% probability of
no movement in response to laryngoscopy and tracheal intubation (MAC- TI).
Patients were allocated randomly to one of four fentanyl dose groups (0, 1,
2 and 4 micrograms kg-1). Patients in each group received sevoflurane at a
pre-selected end-tidal concentration according to an 'up-down' technique.
After steady state sevoflurane concentration had been maintained for at
least 10 min, fentanyl was administered i.v. Tracheal intubation was
performed 4 min after administration of fentanyl, and patients were
assessed as moving or not moving. Heart rate (HR) and mean arterial
pressure (MAP) were recorded before induction of anaesthesia, just before
administration of fentanyl, just before laryngoscopy for intubation, and
after intubation. The MAC-TI of sevoflurane was 3.55% (95% confidence
intervals 3.32-3.78%), and this was reduced markedly to 2.07%, 1.45% and
1.37% by addition of fentanyl 1, 2 and 4 micrograms kg-1, with no
significant difference in the reduction between 2 and 4 micrograms kg-1,
showing a ceiling effect. Fentanyl attenuated haemodynamic responses (HR
and MAP) to tracheal intubation in a dose-dependent manner, even with
decreasing concomitant sevoflurane concentration. Fentanyl 4 micrograms
kg-1 suppressed the changes in HR and MAP more effectively than fentanyl 1
or 2 micrograms kg-1 at sevoflurane concentrations close to MAC-TI.
CLINICAL INVESTIGATIONS
Sevoflurane requirements for tracheal intubation with and without fentanyl
Department of Anaesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu, 431-31 Japan
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Soulard, F. Babre, M. Bordes, Y. Meymat, F. Sztark, and A. M. Cros Optimal dose of sufentanil in children for intubation after sevoflurane induction without neuromuscular block Br. J. Anaesth., May 1, 2009; 102(5): 680 - 685. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Alpiger, H. S. Helbo-Hansen, W. Vach, and H. Ording Efficacy of A-lineTM AEP Monitor as a tool for predicting acceptable tracheal intubation conditions during sevoflurane anaesthesia Br. J. Anaesth., May 1, 2005; 94(5): 601 - 606. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Woods and S. Allam Tracheal intubation without the use of neuromuscular blocking agents Br. J. Anaesth., February 1, 2005; 94(2): 150 - 158. [Full Text] [PDF]
|
|
|
|
|
|
M. Tanaka and T. Nishikawa Propofol requirement for insertion of cuffed oropharyngeal airway versus laryngeal mask airway with and without fentanyl: a dose-finding study Br. J. Anaesth., January 1, 2003; 90(1): 14 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. D. Politis, M. J. Frankland, R. L. James, J. F. ReVille, M. P. Rieker, and B. C. Petree Factors Associated with Successful Tracheal Intubation of Children with Sevoflurane and No Muscle Relaxant Anesth. Analg., September 1, 2002; 95(3): 615 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Takahashi, T. Mizutani, M. Miyabe, and H. Toyooka Hemodynamic Responses to Tracheal Intubation with Laryngoscope Versus Lightwand Intubating Device (Trachlight(R)) in Adults with Normal Airway Anesth. Analg., August 1, 2002; 95(2): 480 - 484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Matute, E. Alsina, R. Roses, G. Blanc, C. Perez-Hernandez, and F. Gilsanz An Inhalation Bolus of Sevoflurane Versus an Intravenous Bolus of Remifentanil for Controlling Hemodynamic Responses to Surgical Stress During Major Surgery: A Prospective Randomized Trial Anesth. Analg., May 1, 2002; 94(5): 1217 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Iamaroon, S. Pitimana-aree, C. Prechawai, J. Anusit, K. Somcharoen, and O. Chaiyaroj Endotracheal Intubation with Thiopental/Succinylcholine or Sevoflurane-Nitrous Oxide Anesthesia in Adults: A Comparative Study Anesth. Analg., February 1, 2001; 92(2): 523 - 528. [Abstract] [Full Text] [PDF]
|
|