Indian Journal of Clinical Anaesthesia 2022;9(4):473–478 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Clinical Anaesthesia Journal homepage: www.ijca.in Original Research Article The comparative efficacy of two different doses of fentanyl on hemodynamic response to laryngoscopy and tracheal intubation: Prospective, randomized control trail Vidhi Vishnubhai Patel 1 , Neel Vishnubhai Patel 2, *, Darshna Dharmendra Patel 3 , Priyanka Jagdishchandra Patel 3 , Hetal Girishkumar Kotecha 1 , Urvisha Avchar Mendpara 1 1 Medical College Baroda, Vadodara, Gujarat, India 2 VS Hospital, Gurgaon, Haryana, India 3 Government Medical College, Vadodara, Gujarat, India ARTICLE INFO Article history: Received 17-07-2022 Accepted 10-09-2022 Available online 15-11-2022 Keywords: Etomidate Hemodynamic response Endotrachial intubation ABSTRACT General anaesthesia with muscle relaxants using controlled ventilation involves laryngoscopy and tracheal intubation, which is associated with haemodynamic changes in the form of tachycardia and hypertension due to increased sympathoadrenal activity and are probably of no consequence in healthy individuals, but they may be hazardous to those with Myocardial Insufficiency and cerebrovascular disease. The objective of the present study was to compare the effect of two different doses of fentanyl with etomidate as an induction agent in attenuating haemodynamic stress response during laryngoscopy and endotracheal intubation. A randomised control trial was carried out on 60 adult patients (ASA I, II, III) undergoing elective surgery under general anaesthesia requiring endotracheal intubation. The patients were randomly allocated into two groups of 30 each i.e. group F2.5 and group F5 receiving fentanyl 2.5 μg/kg and 5 μg/kg intravenously five minutes before intubation respectively. The pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded at various time intervals up to ten minutes after intubation. The study showed that both the doses were equally effective in blunting the pulse rate response, but the 5 μg /kg proved significantly effective in blunting the blood pressure response. The rate pressure product, a measure of cardiac O2 consumption was found to be significantly lower in fentanyl 5 μg/kg compared to fentanyl 2.5 μg/kg. Hence, we conclude that fentanyl in 5 mcg/kg dose is more effective in attenuating hemodynamic responses to intubation as compared to 2.5 mcg/kg. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction Laryngoscopy and tracheal intubation is an intense, noxious stimulation which is associated with hemodynamic changes due to reflex autonomic discharge. 1 There is a necessity to blunt this response to prevent deleterious effects like arrhythmias, myocardial ischemia, increased intracranial pressure, rupture of cerebral aneurysm etc. 2 Various * Corresponding author. E-mail address: vidhiwise@gmail.com (N. V. Patel). drugs like intravenous lidocaine, adrenergic blocking drugs like alpha blockers and beta blockers, vasodilators like nitroprusside, nitroglycerin, hydralazine and intravenous opioids are used for attenuation of hemodynamic response to laryngoscopy and tracheal intubation. Various studies have already discovered that fentanyl 2mcg/kg is effective in attenuating this cardiovascular responses. 2–7 However, in this studies thiopentone 3 and propofol 6 are used as induction agents. Very few studies have been carried out https://doi.org/10.18231/j.ijca.2022.095 2394-4781/© 2022 Innovative Publication, All rights reserved. 473