@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2015;20(4):237-242
ISSN: 2252-0805 The Horizon of Medical Sciences 2015;20(4):237-242
Comparison of Clonidine and Fentanyl Premedication on Hemodynamic Factors in Opium-Dependent Patients Under Endotracheal Intubation
ARTICLE INFO
Article Type
Original ResearchAuthors
Hamzeyi A. (1 )Basiri Moghaddam M. (2 )
Mohammadpour A. (3 )
Talayi A.R. (* )
(* ) Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(1 ) Anesthesia & Operating Room Department, Paramedical Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(2 ) Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(3 ) Internal Surgery Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
Correspondence
Address: No. 10, Mahdi 3, Sa’di Town, Gonabad, IranPhone: +985157231113
Fax: +985157231116
tahermojtaba@gmail.com
Article History
Received: September 10, 2014Accepted: December 24, 2015
ePublished: February 19, 2015
ABSTRACT
Aims
Endotracheal intubation can increase sympathetic reflex activity result in blood pressure
increase, arrhythmia and tachycardia. This study aimed to compare the effects of Clonidine
premedication and Fentanyl on hemodynamic factors(heart rate, systolic and diastolic blood
pressure) in opium-dependent patients under endotracheal intubation.
Materials & Methods This single-blind clinical trial was done on 60 opium-dependent patients undergoing elective surgery under general anesthesia with endotracheal intubation in 2013 at operating room of 15 Khordad hospital. The samples were divided randomly into two equal groups receiving Clonidine and Fentanyl. Systolic and diastolic blood pressure and heart rate were compared before, immediately and 5min after intubation.Data were analyzed using Independent-T, ANOVA and Pearson correlation coefficient tests by SPSS 16 Software.
Findings The mean heart rate, systolic and diastolic blood pressure before endotracheal intubation in both groups was not statistically different (p>0.05) but the mean heart rate, systolic and diastolic blood pressure, immediately after intubation in both groups was maximum and showed significant difference statistically (p<0.001). Systolic and diastolic blood pressure in Clonidine group, 5min after intubation significantly decreased compared with prior to intubation and showed significant difference to the Fentanyl group statistically (p<0.001).
Conclusion Using Fentanyl as a premedication before laryngoscopy and endotracheal intubation is less effective than Clonidine to control of hemodynamic parameters in opiumdependent patients.
Materials & Methods This single-blind clinical trial was done on 60 opium-dependent patients undergoing elective surgery under general anesthesia with endotracheal intubation in 2013 at operating room of 15 Khordad hospital. The samples were divided randomly into two equal groups receiving Clonidine and Fentanyl. Systolic and diastolic blood pressure and heart rate were compared before, immediately and 5min after intubation.Data were analyzed using Independent-T, ANOVA and Pearson correlation coefficient tests by SPSS 16 Software.
Findings The mean heart rate, systolic and diastolic blood pressure before endotracheal intubation in both groups was not statistically different (p>0.05) but the mean heart rate, systolic and diastolic blood pressure, immediately after intubation in both groups was maximum and showed significant difference statistically (p<0.001). Systolic and diastolic blood pressure in Clonidine group, 5min after intubation significantly decreased compared with prior to intubation and showed significant difference to the Fentanyl group statistically (p<0.001).
Conclusion Using Fentanyl as a premedication before laryngoscopy and endotracheal intubation is less effective than Clonidine to control of hemodynamic parameters in opiumdependent patients.
CITATION LINKS
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[2]Alijanpour E, Amry P, Rezaei Moghaddam A. Comparison of intravenous magnesium sulfate and lidocaine on hemodynamic changes during intubation. J Babol Univ Med Sci. 2006;8(4):20-5.
[3]Ko DD, Kang H, Yang SY, Shin HY, Baek CW, Jung YH, et al. A comparison of hemodynamic change after endotracheaql intubation by the Optiscope and the conventional laryngoscope. Korean J Anesthesiol. 2012;63(2):130-5.
[4]Kovac AL. Controlling the hemodynamic respose to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996;8(1):63-79.
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[7]Sameenakousar, Mahesh, Srinivasan KV. Comparison of fentanyl and clonidine for attenuation of the haemodynamic response to laryngocopy and endotracheal intubation. J Clin Diagn Res. 2013;7(1):106-11.
[8]Jabbary Moghaddam M, Ommi D, Mirkheshti A, Dabbagh A, Memary E, Sadeghi A, et al. Effect of clonidine premedication Upon postoperative shivering and Recovery Time in patients With and Without Opium Addiction After Elective leg Fracture Surgeries. Anesth Pain. 2013;2(3):107-10.
[9]Imani F. Text book of pain. J Anesthesiology. 2013;3(3):0-133.
[10]Miler RD, Eriksson LI, Fleisher L, Wiener-Kronish JP, Young WL. Miller's Anesthesia. 7th ed. London: Churchil Livingstoon. 2010;27:214.
[11]Katzung B, Masters S, Trevor A. Basic & Clinical pharmacology. New York: McGraw-Hill Medical; 2012.
[12]Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth. 1987;59(3):295-9.
[13]Kobayashi TL, Watanabe K, Lto T. Lack of effect of i.v. lidocaine on cardiovascular responses to laryngoscopy and intubation. Masui. 1995;44(4):579-82.
[14]Muzi M, Goff DR, Kampine JP, Roerig DL, Ebert TJ. Clonidine reduces sympathetic activity but maintains baroreflex responses in normotensive humans. Anesthesiology. 1992;77(5):864-71.
[15]Dipak LR, Malini KM. Oral clonidine pre medication for attenuation of haemodynamic response to laryngoscopy and intubation. Indian JAnaesth. 2002;46(2):124-9.
[16]Talebi H, Nourozi A, Fateh S, Mohammadzadeh A, Eghtesadi-Araghi P, Jabbari S, Kalantarian M. Effects of oral clonidine premedication on haemodynamic response to laryngoscopy and tracheal intubation: A clinical trial. Pak J Biol Sci. 2010;13(23):1146-50.
[17]Khosravi M, Azemate S, Sheibani N. Comparison of magnesium sulfate with fentanyl and lidocaine on changes induced by laryngoscopy and intubation during coronary artery surgery. J Med Faculty Gilan Univ Med Sci. 2004;8(52):41-7.
[18]Sayyedy Arany H. Effect of intravenous fentanyl on heart rate and rhythm changes induced by tracheal intubation in patients undergoing elective abdominal surgery. Hormozgan Med J. 2001;6(2):39-45.
[19]Yokota S, Komatsu T, Yano K, Taki K, Shimada Y. Effect of oral clonidine premedication on hemodynamic response during sedated nasal fiberoptic intubation. Nagoya J Med Sci. 1998;61(1-2):47-52.
[20]Kalra NK, Verma A, Agarwal A, Pandey HD. Comparative study of intravenously administered clonidine and magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2011;27(3):344-8.
[2]Alijanpour E, Amry P, Rezaei Moghaddam A. Comparison of intravenous magnesium sulfate and lidocaine on hemodynamic changes during intubation. J Babol Univ Med Sci. 2006;8(4):20-5.
[3]Ko DD, Kang H, Yang SY, Shin HY, Baek CW, Jung YH, et al. A comparison of hemodynamic change after endotracheaql intubation by the Optiscope and the conventional laryngoscope. Korean J Anesthesiol. 2012;63(2):130-5.
[4]Kovac AL. Controlling the hemodynamic respose to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996;8(1):63-79.
[5]Brunton L, Chabner B, Knollman B. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw-Hill Professional; 2001.
[6]Ebert JP, Pearson JD, Gelman S, Harris C, Bradley EL. Circulatory response to laryngoscopy. The comparative effects of placebo. Can J Anaesth. 1989;36(3 Pt 1):301-6.
[7]Sameenakousar, Mahesh, Srinivasan KV. Comparison of fentanyl and clonidine for attenuation of the haemodynamic response to laryngocopy and endotracheal intubation. J Clin Diagn Res. 2013;7(1):106-11.
[8]Jabbary Moghaddam M, Ommi D, Mirkheshti A, Dabbagh A, Memary E, Sadeghi A, et al. Effect of clonidine premedication Upon postoperative shivering and Recovery Time in patients With and Without Opium Addiction After Elective leg Fracture Surgeries. Anesth Pain. 2013;2(3):107-10.
[9]Imani F. Text book of pain. J Anesthesiology. 2013;3(3):0-133.
[10]Miler RD, Eriksson LI, Fleisher L, Wiener-Kronish JP, Young WL. Miller's Anesthesia. 7th ed. London: Churchil Livingstoon. 2010;27:214.
[11]Katzung B, Masters S, Trevor A. Basic & Clinical pharmacology. New York: McGraw-Hill Medical; 2012.
[12]Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth. 1987;59(3):295-9.
[13]Kobayashi TL, Watanabe K, Lto T. Lack of effect of i.v. lidocaine on cardiovascular responses to laryngoscopy and intubation. Masui. 1995;44(4):579-82.
[14]Muzi M, Goff DR, Kampine JP, Roerig DL, Ebert TJ. Clonidine reduces sympathetic activity but maintains baroreflex responses in normotensive humans. Anesthesiology. 1992;77(5):864-71.
[15]Dipak LR, Malini KM. Oral clonidine pre medication for attenuation of haemodynamic response to laryngoscopy and intubation. Indian JAnaesth. 2002;46(2):124-9.
[16]Talebi H, Nourozi A, Fateh S, Mohammadzadeh A, Eghtesadi-Araghi P, Jabbari S, Kalantarian M. Effects of oral clonidine premedication on haemodynamic response to laryngoscopy and tracheal intubation: A clinical trial. Pak J Biol Sci. 2010;13(23):1146-50.
[17]Khosravi M, Azemate S, Sheibani N. Comparison of magnesium sulfate with fentanyl and lidocaine on changes induced by laryngoscopy and intubation during coronary artery surgery. J Med Faculty Gilan Univ Med Sci. 2004;8(52):41-7.
[18]Sayyedy Arany H. Effect of intravenous fentanyl on heart rate and rhythm changes induced by tracheal intubation in patients undergoing elective abdominal surgery. Hormozgan Med J. 2001;6(2):39-45.
[19]Yokota S, Komatsu T, Yano K, Taki K, Shimada Y. Effect of oral clonidine premedication on hemodynamic response during sedated nasal fiberoptic intubation. Nagoya J Med Sci. 1998;61(1-2):47-52.
[20]Kalra NK, Verma A, Agarwal A, Pandey HD. Comparative study of intravenously administered clonidine and magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2011;27(3):344-8.