Effect of Sufentanil Plus Propofol Versus Fentanyl Plus Propofol on the Cardiovascular Response to Laryngoscopy and Endotracheal Intubation

Abstract

Background: This study aims to determine the impact of fentanyl and sufentanil in combination with propofol on heart rate and blood pressure changes following laryngoscopy and tracheal intubatio. Methods: In this clinical trial, 96 patients undergoing laryngoscopy were allocated to three groups of 32 individuals each. The three groups received three µg/kg fentanyl, 0.3 µg/kg sufentanil, and a similar volume of normal saline along with other drugs during induction of anesthesia. Hemodynamic parameters were assessed and compared at baseline, just before laryngoscopy, and at minutes 1, 3, 5, and 10 after laryngoscopy across the three groups. Findings: During the study period, among the fentanyl, sufentanil, and normal saline groups, 15 (46.9), 2 (6.3), and 28 (87.5) patients experienced tachycardia, respectively (P < 0.01). Bradyarrhythmia occurred in 8 (25), 3 (9.4), and 1 (3.1) patients in the respective groups (P = 0.036). Additionally, 16 (50), 9 (28.1), and 24 (75) patients in the same order experienced increased blood pressure (P = 0.001), and the differences between the three groups were significant. Hypotension frequency was 2 (6.3), 2 (6.3), and 0 (0) in the three groups, with no significant difference between them (P = 0.54). Conclusion: Both propofol-fentanyl and propofol-sufentanil drug combinations, compared to the control group receiving propofol-normal saline, led to the modulation of blood pressure and heart rate in patients undergoing tracheal intubation. However, fewer hemodynamic disturbances, including tachycardia, bradyarrhythmia, and hypertension, were observed in sufentanil groups. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved.