EFFECT OF REMIFENTANIL BOLUS VS FENTANYL IN ATTENUATING HEMODYNAMIC RESPONSE IN VIDEOLARYNGOSCOPIC ENDOTRACHEAL INTUBATION

Volume 13 , Issue 2 , July 2025 , Pages 107-115

Authors

Shakho Jamal Jalal 1 ; Amir Murad Khudadad 2

1 Shorsh Teaching Hospital,Sulaimani, Kurdistan Region, Iraq.

2 College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10403

Keywords

Abstract

Background
Elevation of blood pressure and pulse rate are hemodynamic changes that occur during general anesthesia as a
consequence of laryngoscopy and endotracheal intubation ETI, different laryngoscopies and many drugs have
been tried to reduce these changes.
Objectives
To evaluate and compare the efficacy of minimum dose of fentanyl and comparable remifentanil bolus dose
during videolaryngoscopic ETI.
Patients and Methods
A triple blind randomized clinical trial implemented on 224 patients of age group between 16-65 years of
either sex (ASA I and ASA II) scheduled for elective operation under general anesthesia with endotracheal
intubation, they are randomly assigned into two groups, group A and group B representing both fentanyl
and remifentanil as the drug preparation was unknown neither by the patient nor by the researcher and nor
by the data analyser, in addition propofol two mg/kg and rocuronium 0.8 mg/kg were given then systolic
blood pressure SBP, diastolic blood pressure DBP, mean arterial blood pressure MAP and heart rate HR were
recorded in five different occasions as (T0) for baseline preinduction, (T1) one minute before ETI, (T2) one
minute after ETI, (T3) three minutes after ETI and (T4) five minutes after ETI.
Results
There was a significant difference in the mean value of HR, SBP, DBP, MAP in both groups before, one,
three and five minutes after endotracheal intubation with King vision videolaryngoscope KVVL and one μg/
kg remifentanil bolus administration (group B) effectively showed substantial reduction in all hemodynamic
parameters with significant statistical result (P < 0.05) when compared to intravenous IV fentanyl one μg/kg
(group A).
Conclusion
Remifentanil bolus of one μg/kg is better than intravenous fentanyl one μg/kg in attenuating hemodynamic
response to ETI when KVVL used.

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  • First online26 July 2025
  • Published at26 July 2025

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