بررسي تاثير تزريق داخل وريدي فنتانيل بر تغييرات تعداد و ريتم ضربان قلب ناشي از لوله گذاري تراشه در بيماران تحت جراحي هاي الكتيوشكمي

Effect of intravenous fentanyl on cardiac rate and rhythm changes due to endothracheal intubation in patients under elective abdominal surgeries

Cardiovascular reactions due to laryngoscopy and endothracheal intubation is transient and non-dangerous in healthy persons but it is significantly dangerous in patients with a history of cardiovascular diseases. This study was carried out to clarify the level of these changes and the effect of fentanyl on these changes in patients under elective abdominal surgeries in Shahid Beheshti Hospital of Kashan during a six-month period (1996-97). This study performed with clinical trial strategy on 100 patients (class 1, II ASA) who were admitted to operation theatre for elective abdominal surgery. The patients were randomly divided in two groups. One group did not received fentanyl (group A) and the other one (group B) received fentanyl before induction of anesthesia. The heart rate and cardiac rhythm parameters were estimated in both groups before induction of anesthesia, endothracheal intubation and 1,2 and 3 minutes after endothracheal incubation. Chi-square test was used for data analysis and p < 0.05 was treated as significant. The mean of heart rate in 1,2 and 3 minutes after endothrachcal in group A and B were 9.2 f 5.58 and 2.4 + 6.92, respectively (P<0.05). Results of statistical analysis showed that changes of heart rate according to age and sex were not significant but changes in heart rate and cardiac rhythm between two groups were significant. This study showed that injection of fentanyl (2micro/kg) 2 minutes before induction of anesthesia can be effective in reducing heart rate and cardiac rhythm changes. Future analytic studies are recommend for estimating effect of fentanyl in decreasing cardiovascular reactions due to endothracheal intubation in patients with ischemic heart disease and hypertension and comparison of fentanyl with other opioid drugs.