The Effects of Two Different Doses of Sublingual Sufentanil on Hemodynamic Changes During Laryngoscopy and Tracheal Intubation

Document Type : Original Article(s)

Authors

1 Professor, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Post Graduate Student, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v43.i835.1319

Abstract

Background: Hemodynamic disturbance is one of the most challenging complications during laryngoscopy. This study was conducted with the aim of comparing the effect of two doses of 0.1 and 0.2 μg/kg sufentanil on the hemodynamics of patients during and after laryngoscopy.
Methods: In this clinical trial study, 96 patients who were candidates for surgery under general anesthesia were divided into three groups of 32. Patients in the first and second groups received 0.1 µg/kg and 0.2 µg/kg of sublingual sufentanil (the sufentanil ampoule was administered sublingually into the oral cavity), respectively, three minutes before the induction of anesthesia. In the third group, normal saline was administered sublingually as a placebo three minutes before anesthesia induction. The patients' hemodynamic parameters were evaluated before laryngoscopy and at 1, 3, 5, and 10 minutes after laryngoscopy, and then compared between the three groups.
Findings: Before laryngoscopy, there was no significant difference among the three groups regarding heart rate, blood pressure, or blood oxygen saturation. Changes in systolic, diastolic and mean arterial blood pressure were significantly different between the three groups (P < 0.001) However, the differences in the changes of heart rate (P = 0.059) and blood oxygen saturation percentage (P = 0.237) were not significant among the three groups.
Conclusion: The use of 0.2 μg/kg of sublingual sufentanil before laryngoscopy reduce hemodynamic disturbance during and after laryngoscopy, and it seems that the patients who receive this medication dose, have more hemodynamic stability during and after laryngoscopy.

Highlights

Azim Honarmand: Google Scholar, PubMed

Mohammadreza Safavi: Google Scholar, PubMed

Keywords

Main Subjects


  1. Hashemi SJ, Soltani HA, Nazemoroaya B, Zangal Giah D, Soleymani B. Effect of laryngoscope blade cover on bacterial contamination of pharynx and post-operative sore- throat [in Persian]. J Isfahan Med Sch 2007; 25(84): 25-16.
  2. Nazemroaya B, Ghosouri A, Honarmand A, Hashemi ST. Comparison of hemodynamic changes and serum potassium levels in the use of succinylcholine and cisatracurium in electroconvulsive therapy. J Res Med Sci 2021; 26: 106.
  3. Nazemroaya B, Jabalameli M, Kamali A. Assessing the effects of dexmedetomidine and labetalol on changes in heart rate and blood pressure after laryngoscopy compared to a control group. J Cell Mol Anesth 2020; 5(2): e149597.
  4. Baradari AG, Firouzian A, Kiasari AZ, Aarabi M, Emadi SA, Davanlou A, et al. Effect of etomidate versus combination of propofol-ketamine and thiopental-ketamine on hemodynamic response to laryngoscopy and intubation: a randomized double blind clinical trial. Anesth Pain Med 2016; 6(1): e30071.
  5. Koh GH, Jung KT, So KY, Seo JS, Kim SH. Effect of different doses of intravenous oxycodone and fentanyl on intubation-related hemodynamic responses: A prospective double-blind randomized controlled trial (CONSORT). Medicine (Baltimore) 2019; 98(18): e15509.
  6. Xue FS, Liu KP, Liu Y, Chao Xu Y, Liao X, Zhang GH, et al. Assessment of small-dose fentanyl and sufentanil blunting the cardiovascular responses to laryngoscopy and intubation in children. Paediatr Anaesth 2007; 17(6): 568-74.
  7. Moradi-Farsani, D., Hatami-Maskooni, M. R., Nazemolroaya, B. Comparing the effects of fentanyl and sufentanil on hemodynamic parameters and acute pain intensity after deep vitrectomy surgery [in Isfahan]. J Isfahan Med Sch 2018; 36(477): 419-25.
  8. Choi BH, Lee YC. Effective bolus dose of Sufentanil to attenuate cardiovascular responses in Laryngoscopic double-lumen Endobronchial intubation. Anesth Pain Med 2016; 6(2): e33640.
  9. Li Y, Song B, Li Z, Wan J, Luo M, Wei W, et al. Comparison of the Effects of Sufentanil and Fentanyl on Postoperative Sleep Quality of Children Undergoing Tonsillectomy and Adenotomy: A Randomized Controlled Trial. Nat Sci Sleep 2021; 13: 2085-6.
  10. Liao X, Yang QY, Xue FS, Luo MP, Xu YC, Liu Y, et al. Bolus dose remifentanil and sufentanil blunting cardiovascular intubation responses in children: a randomized, double-blind comparison. Eur J Anaesthesiol 2009; 26(1): 73-80.
  11. Santos L, Zheng H, Singhal S, Wong M. Remifentanil for tracheal intubation without neuromuscular blocking drugs in adult patients: a systematic review and meta-analysis. Anaesthesia 2024; 79(7): 759-69.
  12. Hashemian AM, Doloo HZ, Saadatfar M, Moallem R, Moradifar M, Faramarzi R, Sharifi MD. Effects of intravenous administration of fentanyl and lidocaine on hemodynamic responses following endotracheal intubation. Am J Emerg Med 2018; 36(2): 197-201.
  13. Nazemroaya B, Mahjobipoor H, Saberi E. Effect of low-dose ketamine versus lidocaine on hemodynamic response to endotracheal intubation in general anesthesia: a prospective, triple-blinded, randomized controlled trial [in Persian]. Tehran Univ Med J 2023; 81(3): 183-92.
  14. Chen P, Zeng P, Gong Y, Long X. Recommended dose of sufentanil during induction of general anesthesia to avoid coughing and drastic hemodynamic fluctuations in patients undergoing surgery. J Int Med Res 2021; 49(3): 0300060521996143.
  15. Mireskandari SM, Abulahrar N, Darabi ME, Rahimi I, Haji-Mohamadi F, Movafegh A. Comparison of the effect of fentanyl, sufentanil, alfentanil and remifentanil on cardiovascular response to tracheal intubation in children. Iran J Pediatr 2011; 21(2): 173-80.
  16. Cook TM. A new practical classification of laryngeal view. Anaesthesia 2000; 55(3): 274-9.