Background: Laryngoscopy and tracheal intubation provoke significant sympathetic stimulation, leading totransient but marked increases in heart rate and blood pressure. Fentanyl, a synthetic opioid, is widely used toblunt this response. This study evaluates the comparative efficacy of two different intravenous fentanyl doses inattenuating these hemodynamic changes.Objectives: To compare the hemodynamic responses—specifically systolic blood pressure (SBP), diastolic bloodpressure (DBP), mean arterial pressure (MAP), and heart rate (HR)—to laryngoscopy and tracheal intubationfollowing administration of 2 μg/kg and 4 μg/kg fentanyl.Methods: This prospective study was conducted on 120 adult patients aged 18–60 years undergoing electivesurgery under general anesthesia. Patients were randomly allocated into two groups: Group F2 received 2 μg/kgfentanyl, and Group F4 received 4 μg/kg fentanyl 5 minutes before induction. Hemodynamic parameters wererecorded at baseline, after fentanyl, post-induction, and at 1, 3, and 5 minutes post-intubation.Results: Both groups experienced an increase in HR and BP after intubation; however, Group F4 showedsignificantly blunted responses across all parameters. The rise in SBP, DBP, MAP, and HR was significantlylower in Group F4 at all measured time points post-intubation (p < 0.05).Conclusion: Higher dose fentanyl (4 μg/kg) more effectively attenuates the pressor and tachycardic responses tolaryngoscopy and tracheal intubation compared to the standard 2 μg/kg dose, without any notable adverse effects.
Neelam et al. (Thu,) studied this question.
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