Effect of pre-extubation low-dose fentanyl on attenuation of haemodynamic response and quality of extubation: A prospective randomised trial

Emergence from anaesthesia, tracheal stimulation during extubation alters the hemodynamics, and coughing generates aerosol that needs to be avoided. The study aimed to evaluate the effectiveness of low doses (0.5 μg/kg) of fentanyl at the end of the surgery in attenuating hemodynamic response and ex...

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Bibliographic Details
Published in:	Trends in anaesthesia & critical care Vol. 39; pp. 44 - 48
Main Authors:	Kireeti, A., Jonnavithula, Nirmala, Sundar, Ayya Syama, kar, Akhya kumar, Prashanth, N.V.S.S.K., Shiva priya, K., Veronica, J.
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01-08-2021
Subjects:	Anaesthesia Fentanyl Hemodynamics response Laparoscopic cholecystectomy Tracheal extubation Anaesthesia Fentanyl Tracheal extubation Laparoscopic cholecystectomy Hemodynamics response
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Summary:	Emergence from anaesthesia, tracheal stimulation during extubation alters the hemodynamics, and coughing generates aerosol that needs to be avoided. The study aimed to evaluate the effectiveness of low doses (0.5 μg/kg) of fentanyl at the end of the surgery in attenuating hemodynamic response and extubation quality. This prospective, randomized, double-blind trial was conducted in a tertiary care center, with a total of 70 ASA PS I&II patients scheduled for elective laparoscopic cholecystectomy. Standard protocol followed for induction of the patients. At the end of the surgery, patients were randomly allocated to either Group-F and Group-C to receive intravenous fentanyl 0.5 μg/kg or an equal volume of normal saline respectively. Hemodynamic parameters before and after the drug, at awakening, while extubation (T0), one and minutes post-extubation (T1&T5 respectively) were measured. Airway reflex scores (ARS), extubation quality score (EQS), and Ramsay sedation scores (RSS) monitored during extubation. Group-C patients had significantly higher mean arterial pressure at T1 (P = 0.021), higher incidence of agitation at T0(P = 0.002), T1(P = 0.002), and T5 (P = 0.009). Group-F patients had significantly better ARS at T0 and T1 (P < 0.001) and better EQS (P < 0.001). Low-dose fentanyl at the time of extubation is an effective way to achieve smooth extubation, control unstable hemodynamics and agitation. •Administering Low dose (0.5 μg/kg) fentanyl at the end of surgery is associated with.•Attenuating haemodynamic response to extubation.•Better scores for airway reflex to suction.•Better quality of extubation.
ISSN:	2210-8440
DOI:	10.1016/j.tacc.2021.04.002