Attenuation of Stress Responses to Tracheal Extubation by Use of Fentanyl after Minor Intra-abdominal Surgery

Abstract

This study was carried out in Assiut University Hospital on 60 patients undergoing minor intraabdominal surgery. Ail patients were ASA physical state I or II . All patients were free from any hepatic, renal, respiratory, neurological or cardiac diseases before surgery. Surgery was performed under standard general anaesthetic technique for all patients. The patients were allocated into three groups; group I received fentanyl IJ.Lg/kg i.v., group 2 received fentanyl 2).1glkg i.v. and group three received saline (control group). All the drugs were given at the time of peritoneal closure. Haemodynamic data (heart rate, systolic, diastolic and mean blood pressure) were recorded irmnediately before induction of anesthesia, at skin incision, at time of injection of the studied drug, at completion of surgery, at tracheal extubation and at 5 minutes after tracheal extubation, and were compared in the three groups .

The quality of tracheal extubation was evaluated in the three groups, using 5 point scale. I = No cough or strain, 2 = Very smooth, minimal coughing, 3 = Moderate coughing. 4 = large degree of cougl:llngc" or straining and, 5 = Poor extubation, very uncomfortable. Serum contrisol level was assessed just before injection of the studied drug and at 5 minutes after tracheal extubation.

The arterial oxygen saturation (Sa02) and the arterial carbon dioxide tension (PaC02) were assessed immediately postoperatively, at I hour and at 3 hours postoperatively.