ประสิทธิผลของยาระงับปวด Fentanyl ที่ให้นำไปก่อนการนำสลบด้วยยา Propofol ในการใส่หน้ากากครอบกล่องเสียงชนิด ProsealTM

บทคัดย่อ

Objectives: To compare the effect of pretreatment fentanyl followed by propofol and propofol administered alone on Proseal^TM insertion conditions and hemodynamics profile.

Materials and methods: In a prospective, randomized controlled study, 120 non-premedicated, ASA physical status 1 and 2 patients undergoing elective surgery were divided into two groups to receive either fentanyl 1 μg./kg (study group, n = 60) or saline (control group, n = 60) three minutes prior to induction of anaesthesia with propofol (1%) 2.5 mg./kg intravenously (IV), followed by Proseal^TM insertion. The insertion conditions (swallowing, coughing, head or limb movement, laryngospasm), jaw relaxation, apnea time and hemodynamic responses between the two groups were compared.

Results: The incidence of jaw relaxation was higher in the control group than the study group. There was no significant difference in terms of swallowing, coughing and movement between the two groups. None of patients developed laryngospasm. The time from the end of induction agent injected to the return of spontaneous ventilation was prolonged in the study group compared with the control group (p < 0.001). mean arterial pressure decreased following induction in both groups. The decrease in mean arterial pressure were greater in patients receiving fentanyl (p = 0.049).

Results: The incidence of jaw relaxation was higher in the control group than the study group. There was no significant difference in terms of swallowing, coughing and movement between the two groups. None of patients developed laryngospasm. The time from the end of induction agent injected to the return
of spontaneous ventilation was prolonged in the study group compared with the control group (p < 0.001).
mean arterial pressure decreased following induction in both groups. The decrease in mean arterial pressure
were greater in patients receiving fentanyl (p = 0.049).

Conclusions: There was no clinical benefit of fentanyl 1 μg./kg given before propofol induction for improving Proseal^TMinsertion conditions compared with propofol administered alone.