Effect of low-dose ketamine versus fentanyl on attenuating the haemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing general anaesthesia: a prospective, double-blinded, randomised controlled trial
| Autor: | Angela Ongewe, Rajpreet Bal, Vitalis Mung’ayi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Low-dose ketamine medicine.medical_treatment endotracheal fentanyl Fentanyl law.invention 0302 clinical medicine Randomized controlled trial law Tachycardia Intubation General anaesthesia Prospective Studies medicine.diagnostic_test Age Factors Articles General Medicine Middle Aged Elective Surgical Procedures Anesthesia Hypertension Female Ketamine Propofol medicine.drug Adult Adolescent 030231 tropical medicine Laryngoscopy intubation Young Adult 03 medical and health sciences Sex Factors Double-Blind Method Intubation Intratracheal medicine Humans Elective surgery laryngoscopy Aged Anesthetics business.industry Hemodynamics Low-dose ketamine fentanyl laryngoscopy endotracheal intubation double-blinded randomised controlled trial Socioeconomic Factors double-blinded business randomised controlled trial |
| Zdroj: | African Health Sciences African Health Sciences; Vol 19, No 3 (2019); 2752-2763 |
| ISSN: | 1680-6905 |
| DOI: | 10.4314/ahs.v19i3.51 |
| Popis: | Background: The use of drugs to attenuate the haemodynamic response to laryngoscopy and endotracheal intubation is the standard of care during elective surgery. Current evidence is conflicting concerning the best agent and optimal dose for this purpose. In the majority of cases, fentanyl is widely utilized to attenuate haemodynamic responses. Ketamine, an established available drug, has been scarcely studied in this regard at low doses and against varying doses of other common agents.Objective: To compare the overall occurrence of hypertension and tachycardia immediately pre-intubation (post-induction) until 10 minutes post intubation between the study group receiving fentanyl at 1.0 µg/kg and the other receiving ketamine at 0.5 mg/kg, to compare the occurrence of post-induction hypotension and the occurrence of neuropsychiatric phenomena during emergence between the two groups.Methods: One hundred and eight ASA I and II patients aged 18-65 years scheduled for elective surgery under general anaesthesia were randomized into two groups: Control group: received fentanyl 1.0 µg/kg intravenously. Intervention group: received ketamine 0.5 mg/kg intravenously. General anaesthesia was standardized in both groups. The patients and physicians administering anaesthesia were blinded to the study. Haemodynamic responses were evaluated by determining heart rate and blood pressure immediately before laryngoscopy and at 2.5, 5, 7.5 and 10 minutes. Neuropsychiatric phenomena were assessed upon recovery from anaesthesia.Results: One hundred and eight ASA I and II patients scheduled to undergo elective surgery were included in this study, 54 participants (50%) in the fentanyl arm and 54 (50%) in the ketamine arm. Baseline demographic characteristics were similar between the groups. There were more hypertensive episodes in the ketamine arm (11%) compared to the fentanyl arm (1.85%), but not achieving statistical significance: Fisher’s exact test, p=0.06. There was no significant difference in the number of episodes of tachycardia between the Ketamine group 7/54 (13%) and the fentanyl group, 6/54 (11%); x2=0.05, p=0.82. Hypotensive episodes were more common in those who received Fentanyl, 41/54 (76%), compared to ketamine recipients, 21/54 (39%), X2=16.9, p |
| Databáze: | OpenAIRE |
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