Optimal dosage of fentanyl combined with intravenous anesthetics during anesthesia induction

Objective To investigate optimal dosage of fentanyl combined with intravenous anesthetics for the prevention of hemodynamic changes to endotracheal intubation during anesthesia induction.Methods 162 patients were randomly divided into seven groups: group Ⅰ thiopental 5 mg/kg and fentanyl 7 μg/kg(n=25);group Ⅱ etomidate 0.3 mg/kg and fentanyl 7 μg/kg(n=28);group Ⅲ etomidate 0.3 mg/kg and fentanyl 5 μg/kg(n=27);groupⅣ midazolam 0.05 mg/kg,etomidate 0.3 mg/kg and fentanyl 6 μg/kg(n=22);groupⅤ propofol 2 mg/kg and fentayl 7 μg/kg(n=15);groupⅥ propofol 2 mg/kg and fentanyl 5 μg/kg(n=15);groupⅦ propofol 2 mg/kg and fentanyl 3 μg/kg(n=30).SBP,DBP,MAP,HR,RPP were monitored before and after induction,0,1,3,5,7,10 min after intubations.Results SBP,DBP,MAP decreased after induction,and 5,7,10 min after intubations.HR increased 1 min after intubation in group Ⅰ(P0.05).Hemodynamics(was stable during) anesthesia induction in group Ⅱ.SBP increased 1 min after intubation in group Ⅲ(P0.01).SBP decreased after induction in group Ⅳ(P0.05).SBP,DBP,MAP decreased significantly during induction and intubations in group Ⅴ(P0.01).SBP,DBP,MAP decreased after intubations and 7,10 min after intubations in group Ⅵ(P0.01).SBP,DBP,MAP decreased only after inductions in group Ⅶ(P0.01).Conclusion Fentanyl 7 μg/kg combined with thiopental or etomidate,fentanyl 6 μg/kg combined with midazolam and etomidate,fentanyl 3 μg/kg combined with propofol are optimum dose of the prevention of homonymic response to end-intubations during anesthesia induction.