Abd Elhafez Nashwa Farouk, Oriquat Ghaleb Ali, Nsairat Hamdi, Jaber Bahaa, Abdelraouf Abdelraouf Ms, Fahmy Marina Kamal, Saleem Tahia H, Abdelall Alshimaa Hafez
Department of Anesthesia, Intensive Care Unit, and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt.
Pharmacological and Diagnostic Research Center, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan.
J Int Med Res. 2025 Feb;53(2):3000605251315023. doi: 10.1177/03000605251315023.
To compare the efficacy of dexmedetomidine and fentanyl to reduce hemodynamic and biochemical stress markers associated with endotracheal intubation under general anesthesia.
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.
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.
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.
比较右美托咪定和芬太尼在全身麻醉下减轻与气管插管相关的血流动力学和生化应激指标的疗效。
2024年1月至6月，我们在阿斯尤特大学对80例患者和20名健康对照者进行了一项前瞻性随机对照研究。患者被分为两组：D组接受右美托咪定，F组接受芬太尼。在四个时间点采集血样：T0（基线）、T1（麻醉诱导后2分钟）、T2（插管后1分钟）和T3（插管后10分钟），用于应激指标分析。
与基线相比，两组插管后应激指标均显著升高。D组在T1、T2和T3时皮质醇、去甲肾上腺素和乳酸浓度显著较低；在T2时血流动力学参数也较低；而F组术后恢复较早。
两种药物均增加了应激指标，但右美托咪定更有效地降低了生化指标浓度，表明其应激控制更好，而使用芬太尼导致恢复更快。右美托咪定在减轻插管诱导的应激方面更有效，而芬太尼有助于术后更快恢复。
