Effect of opioid-free anesthesia induction on hemodynamics of patients with endotracheal intubation

Objective To observe the effect of opioid-free anesthesia (OFA) induction on hemodynamics of patients with endotracheal intubation.

Methods A total of 60 patients with general anesthesia and endotracheal intubation in elective general surgery were randomly divided into observation group and control group, with 30 cases in each group. In the observation group, a dose of 0.5 μg/kg dexmedetomidine was firstly injected intravenously for 5 min, followed by 2.0 mg/kg propofol, 1.5 mg/kg lidocaine and 2.0 mg/kg succinylcholine intravenously for anesthesia induction. In the control group, 0.02 mg/kg midazolam, 2.0 mg/kg propofol, 0.3 μg/kg sufentanil and 2.0 mg/kg succinylcholine were successively injected intravenously for anesthesia induction. In both groups, endotracheal intubation was performed at 1 min after succinylcholine injection, and the intubation was completed within 30 seconds. The blood pressure diastolic pressure (DBP), systolic pressure (SBP), mean arterial pressure (MAP), heart rate (HR) and rate-pressure product (RPP) were compared between the two groups at the time points of hospital admission (T₀), after anesthesia induction (T₁), immediately after intubation (T₂), 1 min after intubation (T₃), 3 min after intubation (T₄), and 5 min after intubation (T₅).

Results Compared with indexes at T₀, the SBP, DBP and MAP at T₁ and T₅ in the control group decreased significantly (P < 0.05); compared with index at T₀, the HR at T₁, T₄ and T₅ in the observation group and at T₄ and T₅ in the control group decreased significantly (P < 0.05); compared with index at T₀, the RPP at T₁, T₄ and T₅ in both groups decreased significantly (P < 0.05). In the observation, the SBP, DBP and MAP at T₁, T₄ and T₅ as well as the RPP at T₅ were significantly higher than those in the control group, while the HR at T₁ was significantly lower than that in the control group (P < 0.05).

Conclusion OFA induction of dexmedetomidine and lidocaine combined with propofol has a certain inhibitory effect on cardiovascular response induced by tracheal intubation, and hemodynamic changes are relatively stable.