Background and Goal of Study: Sevoflurane has been widely used for inhalation induction and intubation in children and adults.1,2 There are some reports about hemodynamic instability and respiratory effects during inhalation induction. We evaluated the effects of fentanyl, lidocaine, or both on inhalation induction and intubation using sevoflurane without neuromuscular blocking agents.
Materials and Methods: Sixty healthy adult female patients, 20 to 60 years old, premedicated with midazolam 3 mg were randomly received i.v. saline (Group A), lidocaine 1 mg/kg (Group B), fentanyl 1 μg/kg (Group C) or both lidocaine 1 mg/kg and fentanyl 1 μg/kg (Group D). Anesthesia was induced with 8% sevoflurane inhalation and intubation was done without muscle relaxant. A blind observer recorded the change of blood pressure, heart rate, BIS score, and the time needed for induction and intubation.
Results and Discussions: The mean times for BIS score below 40 were 87 ± 34 seconds and there were no significant difference among group. The mean times for loss of self respiration and intubation in Group A were significantly longer than those of other groups. The heart rates during induction and intubation of Group A were significantly greater than those of other groups. There was no significant difference in blood pressure and side effects during intubation among groups.
Conclusion(s): Pretreatment with fentanyl or lidocaine make smoother and faster induction and intubation during vital capacity rapid inhalation induction with sevoflurane.
1 Anaesthesia 2000; 55: 774-8.
2 Anesthesiology 1996; 85: 536-43.