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IRCT138905114492N1 IRCT 2009-04-04 Vice chancellor for research, Mazandaran University of Medical Sciences Comparison between drugs on hemodynamic changes during tacheal intubation for CABG comparison between Remifenil, lidocaine and fentanil on hemodynamic changes on CABG during laryngoscopy and tracheal intubation 2009-04-04 anticipated 100 Complete https://irct.ir/trial/4792 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Prevention, Other design features: routine group as a control group. N/A Condition 1: Hemodynamic change, Local anesthesia, tracheal intubation , CABG. Condition 2: Atherosclerotic heart disease. Intervention 1: Remifentanil 0.5 microgram per kilogram , 3 min before laryngoscopy. Intervention 2: Spray of 10% lidocaine 2 puff to supraglotic 3 min before laryngoscopy. Intervention 3: Lidocaine IV 1.5 mg/kg 3 min before laryngoscopy. Intervention 4: Fentanyl 8 micro gram per kilogram 3 min prior Laryngoscopy. Intervention 5: Fentanyl 3-5 Micrograme per kilogram 3 min before laryngoscopy as routine or control group. http://jmums.mazums.ac.ir/browse.php?a_id=610&sid=1&slc_lang=fa Background and purpose: Ït has been found that the use of different drugs for laryngoscopy preparation and tracheal intubation results in controversy. The aim of this study is to compare the haemodynamic effects of remifentanil with fentanyl for tracheal intubation in patients undergoing coronary artery bypass grafting (ÇÂBG). <br /> Materials and methods: This is a randomized and double-blind study. We recruited 64 patients undergoing coronary artery bypass surgery. Subjects received in 3 separate groups: remifentanil, 5 microgram/kg, Fentanyl, 8 microgram/kg, and routine medication respectively. Systolic and diastolic blood pressure, heart rate and mean arterial pressure were measured during, before and after tracheal intubation and immediately, 1, 3, 5, 10, minutes after intubation. Patients were monitored for haemodynamic changes using electrocardiography. <br /> Results: Sixty four patients were enrolled in the study. Twenty four patients age at 66 ± 5.7 (60-84) years, received remifentanil, 23 patients with mean age of 65.7 ± 6 (60-80) years made up the routin group, and 17 patients with mean age of 65 ± 4.8 (61-76) years received fentanyl. Blood pressure and heart rate decreased after induction of anaesthesia in all groups. SBP and DBP significantly decreased in remifentanil group in comparison with other groups (p= 0.01, 0.03). Ït was pssoble to control hemodynamic response to tracheal intubation in all groups, although it was better in remifentanil group than other groups. <br /> Çonclusion: Âlthough the incidence of hypotension was higher, 0.5 microgram/kg of Remifentanil 8 microgram/kg of fentanyl and routine method (sufentanil) were all effective to attenuate patients’ blood pressure in response to tracheal intubation up to 3 minutes after intubation. <br /> <br /> Keywords: Remifentanil, fentanyl, hemodynamic responses, tracheal intubation, sufentanil, <br />
public Dr Mohammad reza Haghshenas
moalem square, Deputy of research of Mazandaran University of Medical Sciences
Sari Iran (Islamic Republic of) 4817844718 +98 15 1325 7230 mhaghshenas@mazums.ac.ir Mazandaran University of Medical Sciences scientific Ebrahim Nasiri
Dept Anesthesia, operating room and Emergency Medicine, Mojtamehe Payambare Azam, Mazandaran University of Medical Sciences, Paramedical school.
Sari Iran (Islamic Republic of) 4818846693 +98 15 1354 3246 rezanf2002@yahoo.com; enasiri@mazums.ac.ir; ebrahim.nasiri.f@gmail.com Mazandaran University of Medical Sciences Iran (Islamic Republic of) Inclusion Criteria are: CABG candidated patients, 50-85 years old, ASA III, IV Exclusion Criteria are : Difficult Intubation, laryngoscopy and tracheal intubation time more than 30 second, more than two time tried for intubation, Sensitivity to local anesthetic drugs 50 years 85 years Both - I25.1 - Atherosclerotic heart disease Treatment - Drugs Treatment - Drugs Treatment - Drugs Treatment - Drugs Treatment - Drugs Remifentanil 0.5 microgram per kilogram , 3 min before laryngoscopy Spray of 10% lidocaine 2 puff to supraglotic 3 min before laryngoscopy Lidocaine IV 1.5 mg/kg 3 min before laryngoscopy Fentanyl 8 micro gram per kilogram 3 min prior Laryngoscopy Fentanyl 3-5 Micrograme per kilogram 3 min before laryngoscopy as routine or control group Systolic Blood pressure. Timepoint: from 2 to 5 minutes. Method of measurement: We used invasive arterial line blood pressure monitoring with datascope prouducted in USA. Diastolic Blood pressure. Timepoint: 2-5 min. Method of measurement: We used invasive arterial line blood pressure monitoring with datascope prouducted in USA. Heart rate. Timepoint: 2- 5 Min. Method of measurement: We used invasive arterial line blood pressure monitoring with datascope prouducted in USA. Premature ventricular contraction (PVC). Timepoint: Before intubation, continuous monitoring after intubation up to the 10th minute. Method of measurement: We used invasive arterial line blood pressure monitoring with datascope prouducted in USA. SPo2. Timepoint: 2- 5 minutes interval. Method of measurement: Pulse Oximetry instrument. Mean arterial pressure. Timepoint: 2-5 Min. Method of measurement: We used invasive arterial line blood pressure monitoring with datascope prouducted in USA. Vice chancellor for research, Mazandaran University of Medical Sciences Approved 2009-03-04 Mazandaran University of Medical Sciences Moalem Square, Chancelar of research of Mazandaran University of Medical Sciences Sari Iran (Islamic Republic of)