Interaction between intubation and stress regarding hemodynamic and hormonal changes

Objective To compare the efficacy of dexmedetomidine and fentanyl to reduce hemodynamic and biochemical stress markers associated with endotracheal intubation under general anesthesia. Methods We performed a prospective randomized controlled study of 80 patients and 20 healthy controls at Assiut Uni...

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Main Authors: Nashwa Farouk Abd Elhafez, Ghaleb Ali Oriquat, Hamdi Nsairat, Bahaa Jaber, Abdelraouf Ms Abdelraouf, Marina Kamal Fahmy, Tahia H. Saleem, Alshimaa Hafez Abdelall
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251315023
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Summary:Objective To compare the efficacy of dexmedetomidine and fentanyl to reduce hemodynamic and biochemical stress markers associated with endotracheal intubation under general anesthesia. Methods We performed a prospective randomized controlled study of 80 patients and 20 healthy controls at Assiut University from January to June 2024. The patients were allocated to two groups: Group D received dexmedetomidine and Group F received fentanyl. Blood samples were collected at four time points: T0 (baseline), T1 (2 minutes after induction of anesthesia), T2 (1 minute after intubation), and T3 (10 minutes post-intubation), for stress marker analysis. Results Intubation significantly increased stress markers in both groups compared to baseline. Group D showed significantly lower cortisol, norepinephrine, and lactate concentrations at T1, T2, and T3; and hemodynamic parameters at T2; whereas Group F demonstrated earlier post-operative recovery. Conclusions Both drugs increased stress markers, but dexmedetomidine more effectively reduced biochemical marker concentrations, suggesting better stress control, whereas fentanyl use led to quicker recovery. Dexmedetomidine is more effective at reducing intubation-induced stress, whereas fentanyl facilitates faster post-operative recovery.
ISSN:1473-2300