The effects of fentanyl anesthesia on the changes of hemodynamic(HR, BP), blood suger, electrolytes and ABGA during induction of anesthesia and cardiopumonary bypass under fentanyl anesthesia were studied in three groups of 30 patients. The results were as follows: 1) The changes of HR & BP were significatly decreased under fentanyl anesthesia compaired to morphine anesthesia. 2) The level of blood sugar was increased during whole procedures in all groups and it was the least in large dose fentanyl group. 3) The changes of electrolyte and arterial blood gas value during CPB were not remakable.
Anesthesia* ; Blood Glucose* ; Electrolytes ; Fentanyl* ; Humans ; Morphine

BACKGROUND: Tracheal intubation can cause sympathetic stimulation such as hypertension and tachycardia. Many drug are used for reducing the incidence of hypertension and tachycardia induced by intubation. Among these drugs, fentanyl can be used with good result. The purpose of this study was to find the appropriate fentanyl injection time before intubation when a small dose (3 microgram/kg) was used. METHODS: We studied 82 ASA class 1 2 patients, scheduled for gynecological elective surgery, randomized into 5 groups. Group 1 received no fentanyl before intubation, and groups 2, 3, 4 and 5 received 3 microgram/kg fentanyl at 7 min, 5 min, 3 min and 1 min before intubation, respectively. The blood pressure and heart rate were checked at preinduction and post-intubation periods for 5 minutes. RESULTS: The increase of the heart rate was significantly lower in groups 2 and 3 than in group 5 just after intubation. Furthermore the increase of the mean blood pressure was significantly lower in groups 2, 3 and 4 than in group 5 just after intubation. The incidence of tachycardia and hypertension was significantly lower in groups 2, 3 and 4 than in group 5 just after intubation. CONCLUSIONS: When a small dose of fentanyl was used to blunt the intubation induced sympathetic stimulation, the appropriate time was prior to 3 minutes before intubation.
Blood Pressure ; Fentanyl* ; Heart Rate ; Humans ; Hypertension* ; Incidence* ; Intubation* ; Tachycardia*

BACKGROUND: Remifentanil is a new member of fentanyl family and a short-acting, esterase-metabolized opioid.This study compared the perioperative characteristics of a remifentanil infusion with those of fentanyl bolus administration as an adjuvant to propofol infusion for the anesthetic management of patients undergoing ureteroscopic lithotripsy. METHODS: Eighty patients were randomly assigned to receive either remifentanil target controlled infusion (R group, effect-site concentration of 4.0 ng/ml for induction followed by 2.0 ng/ml) or fentanyl bolus (F group, 2.0microgram/kg before induction).All patients received propofol infusion as the part of the induction and maintenance.We investigated recovery profiles, adverse events and the ease of insertion of laryngeal mask airway (LMA) between the two groups.Heart rate (HR) and mean blood pressure (MBP) were also compared at baseline (T0), loss of consciousness (T1), insertion of LMA (T2), beginning and end of operation (T3, T4) and removal of LMA (T5). RESULTS: The time from the end of anesthesia to spontaneous respiration, eye opening and LMA removal were significantly shorter for patients receiving remifentanil than for those receiving fentanyl.HR at T3 and T4 were lower in the R group than in the F group.Aldrete recovery score, time to discharge from recovery ward, the ease of insertion of the LMA, MAP and adverse events did not differ significantly between the two groups. CONCLUSIONS: Target controlled infusion of remifentanil combined with propofol can significantly shorten the early recovery time than fentanyl bolus administration without increasing adverse events in patients undergoing ureteroscopic lithotripsy.
Anesthesia ; Blood Pressure ; Eye ; Fentanyl ; Humans ; Laryngeal Masks ; Lithotripsy ; Piperidines ; Propofol ; Respiration ; Unconsciousness

BACKGROUND: Midazolam is often used as an anxiolytic premedication before surgery, but it is difficult and complex to assess its effect. This study evaluated the bispectral index as an objective indicator of midazolam premedication and the relation of cardiovascular response to anesthetic induction. METHODS: Forty patients (aged 20 to 60 and in ASA class I or II) to undergo simple elective surgery under general anesthesia entered the study. The patients were divided into the midazolam group (n = 20) that received midazolam (0.08 mg/kg IM) and glycopyrrolate (0.2 mg IM) premedication, and the control group (n = 20) that received glycopyrrolate (0.2 mg IM) only. Then, anesthetic induction (fentanyl 1 microgram/kg, propofol 2 mg/kg, succinylcholine 1 mg/kg) was done. The bispectral index of the electroencephalogram, blood pressure, and heart rate were measured under unanesthetized conditions, after fentanyl, propofol injection, and intubation. RESULTS: The bispectral index was significantly lower in the midazolam group as compared with the control group before anesthetic induction, after fentanyl injection, and intubation. Blood pressure was not significantly different in the two groups. Heart rate was significantly lower in the midazolam group compared with the control group before anesthetic induction and after fentanyl injection. CONCLUSIONS: Midazolam-premedicated patients appear to maintain stable hemodynamics during anesthetic induction and intubation. The bispectral index can be objectively used in midazolam-premedicated patients when evaluating the degree of sedation. (Korean J Anesthesiol 2000; 38: 947~953)
Anesthesia, General ; Blood Pressure ; Electroencephalography ; Fentanyl ; Glycopyrrolate ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam* ; Premedication* ; Propofol ; Succinylcholine

BACKGROUND: To test whether smokers have exaggerated hemodynamic responses to induction and intubation, we investigated the changes in blood pressure (BP) and heart rate (HR) on induction and intubation in smokers and nonsmokers. METHODS: Healthy male patients (25 smokers and 25 nonsmokers, aged 20 to 29 yrs) for elective surgery were studied. Anesthesia was induced with thiopental 3 mg/kg, fentanyl 1.5 microgram/kg, vecuronium 0.1 mg/kg and maintained with enflurane 1 % in N2O and O2 for the period of observation. After three minutes, orotracheal intubation was performed. Noninvasive BP and HR were recorded one minute before induction (baseline), immediately before intubation, and then every minute until five minutes after intubation. RESULTS: Systolic BP of smokers decreased significantly immediately before intubation, and at 4 and 5 min after intubation as compared to that of nonsmokers (Mean +/- SEM, 120.8 +/- 3.0 vs. 109.9 +/- 2.8, 116.7 +/- 2.4 vs. 108.9 +/- 2.3, and 114.8 +/- 2.2 vs. 106.7 +/- 2.3 mmHg, respectively, P < 0.05). Diastolic BP of smokers decreased only immediately before intubation compared with that of nonsmokers (Mean +/- SEM, nonsmoker 64.6 +/- 2.4 vs. smoker 58.6 +/- 1.8 mmHg, P < 0.05). However, there was no significant difference of HR between smokers and nonsmokers during the observational period. CONCLUSIONS: Hemodynamic response is different in smokers compared with nonsmokers. Our results indicate that smoking affects the hemodynamic response to induction and intubation.
Anesthesia ; Blood Pressure ; Enflurane ; Fentanyl ; Heart Rate ; Hemodynamics* ; Humans ; Intubation* ; Male ; Smoke ; Smoking ; Thiopental ; Vecuronium Bromide

BACKGROUND: The aim of this study was to examine the safety and efficacy of sedation and analgesia using remifentanil during percutaneous endoscopic lumbar discectomy (PELD). METHODS: Eighty ASA patients with physical status 1 or 2 who underwent a PELD were enrolled in this study. They were randomized to receive one of two treatments: a fentanyl bolus of 0.7microgram/kg 5 min before the procedure and of 0.7microgram/kg during the procedure (n = 40, group F), or a remifentanil titration at an infusion rate of 0.1-0.3microgram/kg/min available throughout the procedure according to the appeal of pain, level of sedation and side-effects (n = 40, group R). The observer's assessment of alertness/sedation (OAA/S) scale, blood pressure, heart rate, respiratory rate, SpO2, and end tidal CO2 were assessed and measured during and/or after the procedures. The visual analogue scale of pain (VAS), and the patient and endoscopist satisfaction scale were assessed after the procedures. RESULTS: There were no significant differences between the two groups in terms of the recovery characteristics, incidence of complications and satisfaction score of patients. In 92.5% of the cases among the remifentanil group, the spine surgeon made uniform judgements that remifentanil worked better than the usually used fentanyl procedure, whereas in 7.5% of the cases the effects were indifferent. The VAS score of the R group was significantly lower than that of the F group. CONCLUSIONS: We concluded that sedation and analgesia with remifentanil is very useful for painful local procedures such as PELDs.
Analgesia ; Blood Pressure ; Diskectomy* ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Respiratory Rate ; Spine

BACKGROUND: Fentanyl-induced cough (FIC) has a reported incidence of 13–65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. METHODS: This study enrolled 200 patients aged 18–60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration. Patients in the F+IS group performed incentive spirometry 10 times just before an intravenous bolus of 3 µg/kg fentanyl in the operating room. The onset time and number of coughs after fentanyl injection were recorded as primary outcomes. Any significant changes in blood pressure, heart rate, or adverse effects of the drug were recorded as secondary outcomes. RESULTS: Patients in the F+IS group had a significantly lower incidence of FIC than in the F group (6% vs. 26%) (P < 0.05). The severity of cough in the F+IS group was also significantly lower than that in group F (mild, 5 vs. 17; moderate 1 vs. 7; severe, 0 vs. 2) (P < 0.05). The median onset time was comparable in both groups (9 s [range: 6–12 s] in both groups). CONCLUSIONS: Preoperative incentive spirometry significantly reduces the incidence and severity of FIC when performed just before fentanyl administration.
Anesthesia ; Blood Pressure ; Cough* ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Motivation* ; Operating Rooms ; Prospective Studies* ; Spirometry*

The effect of fentanyl on arterial pressure and heart rate during laryngoscopy and intubation was studied in 40 adult normotensive patients. Two groups of 20 patients were observed. Patients received thiopental sodium 5 mg/kg (contal group) or fentanyl 2 ug/kg with thiopental 5 mg/kg (fentanyl group) for induction of anesthesia. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) were measured during the preinduction period, before thiopental (or thiopental+fentanyl), after succinylcholine, immediately after intubation and 5 minutes after intubation. The values were compared with preinduction control values. The results were as follows: The contro#l group showed a significant inerease of SBP, DBP and MAP (p<0.001) but no significant increase was noted in the fentanyl group with tracheal intubation. DBP and MAP returned to normal within 5 minutes and SBP decreased significantly (p<0.05). Significant heart rate elevation following intubation was observed in both groups. It is suggested from the above results that pretreatment with fentanyl 2 g/kg reduce the blood pressure elevation following intubation but dose not prevent the elevation of heart rate.
Adult ; Anesthesia ; Arterial Pressure ; Blood Pressure ; Fentanyl* ; Heart Rate ; Humans ; Intubation* ; Laryngoscopy* ; Succinylcholine ; Thiopental

The authors have introduced a method of Thalamonai dripping with concomitant use of small doses of Pentothal for rapid and smooth loss of consciousness and induction of anesthesia, and maintaining anesthesia with intermittent injections of Thalamonal and Pavulon as well as N2O inhnlation. From 21 cases, the following results were obtained: 1) Average dose of fentanyl as a premedicant was l. 143ug/kg (Thalamonal, 0. 023cc/kg). 2) Average dose of fentanyl during induction of anesthesia was 3. 48ug/kg (ThaJamonal, 0, 695 cc/10kg), and concomitant injection of Pentothal (average, l. 83mg/kg) achieved rapid and smooth induction of anesthesia. During induction, changes of blood pressure and pulse rate were insignificant. 3) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at every 30 minute interval, and average dose of fentanyl was 0.64ug/kg/30min. 4) Seventeen cases among 21 recovered promptly after discontinuation of N2O, and the recovery was delayed in the, remainder. Two patients had awareness without pain during operation, Delayed recovery of consciousness seemed related to overdosage of the droperidol component in Thalamonal, but not to total operating time.
Anesthesia* ; Blood Pressure ; Consciousness ; Droperidol ; Fentanyl ; Heart Rate ; Humans ; Methods ; Pancuronium ; Thiopental ; Unconsciousness

BACKGROUND: When given as an intravenous bolus for induction of anesthesia, propofol with fentanyl can induce moderate to severe preintubation hypotension and bradycardia. The goal of this study was to evaluate the effect of ephedrine to prevent hypotension and bradycardia and to compare methods of ephedrine administration. METHODS: Forty five patients of ASA physical status 1 or 2 were randomly assigned to one of three groups of 15 patients each to receive either normal saline (G I), ephedrine 0.2 mg/kg IV 2 min before the injection of propofol (G II), or propofol mixed with ephedrine 0.2 mg/kg (G III). Each group first received fentanyl 2ng/kg and 2 min later received propofol 2 mg/kg as an intravenous bolus to induce anesthesia. Anesthesia was maintained by a continuous infusion of propofol 20 mg for 8 min until intubation. The changes of systolic and diastolic arterial pressure, and heart rate were measured before induction (0 min), 2, 4, 6, and 8 min after induction, and post intubation (10 min). RESULTS: The decrease of systolic and diastolic pressure in G II and G III were attenuated compared with those of the control group. The difference was significant at 2, 4, and 6 min in G II, and at 2 and 4 min in G III (P < 0.05). The decrease of heart rate in G II (8 min) and G III (6 and 8 min) were also less marked than those in G I (P < 0.05). The increase of heart rate of post intubation (10 min) was greater in G II and G III than in G I (P < 0.05). There was no statistical difference among the groups in the increase of systolic and diastolic pressures after intubation. CONCLUSIONS: Prophylactic ephedrine significantly attenuated the decrease in blood pressure and heart rate during induction of anesthesia with fentanyl and propofol. There was no statistical difference between the ephedrine groups.
Anesthesia ; Arterial Pressure ; Blood Pressure* ; Bradycardia ; Ephedrine* ; Fentanyl* ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Hysterectomy* ; Intubation ; Propofol*