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Reflex activity caused by laryngoscopy and intubation is obtunded differently by meptazinol, nalbuphine and fentanyl

Published online by Cambridge University Press:  11 July 2006

E. Freye  and
J. V. Levy
E. Freye
Affiliation:
Heinrich-Heine-University of Düsseldorf, Clinics of Vascular Surgery and Renal Transplantation, Düsseldorf, Germany
J. V. Levy
Affiliation:
University of the Pacific (UOP), Department of Physiology and Pharmacology, San Francisco, CA, USA
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Extract

Summary

Background and objective: To evaluate the different potencies of several opioids in obtunding reflex mechanisms of laryngoscopy and intubation. Methods: Three groups of patients (each n = 25, ASA 1–2) undergoing elective plastic surgery were randomly given meptazinol (2.5 mg kg−1 ), nalbuphine (0.3 mg kg−1) or fentanyl (5 μg kg−1) in a blinded fashion prior to laryngoscopy and intubation. This was followed by a standardized bolus induction of a barbiturate and a muscle relaxant. The response to laryngoscopy and intubation was studied, using blood pressure, heart rate and bispectral index. Results: With fentanyl, there was an increase of heart rate by 17%, and systolic blood pressure by 7% when compared to control. Bispectral index dropped an additional 8% when compared to 1 min after barbiturate induction. In the nalbuphine group there was a 16% increase in systolic blood pressure, and a 16% increase in heart rate when compared to control. Also, bispectral index increased by 18% when compared to 1 min after barbiturate injection. The group receiving meptazinol demonstrated no cardiovascular changes although bispectral index dropped by an additional 19% when compared to 1 min after barbiturate injection. Conclusion: Meptazinol, appears to depress cardiovascular stimulatory effects and electroencephalogram arousal induced by laryngoscopy and intubation better than nalbuphine or fentanyl.

Keywords

ANAESTHESIA INTRAVENOUSOPIOID ANALGESICS, fentanyl, meptazinol, nalbuphineLARYNGOSCOPYINTUBATION INTRATRACHEALELECTROENCEPHALOGRAM, bispectral indexHAEMODYNAMIC PHENOMENA, blood pressure, heart rate
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 1 , January 2007 , pp. 53 - 58
Copyright
© 2006 European Society of Anaesthesiology

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