Comparison of Different Dosages of Fentanyl when Etomidate is used as Induction Agent

Our study was a prospective randomised study including 60 patients undergoing elective surgeries under general anaesthesia. They were randomly allocated into two groups of 30 each. Group I received 2 microgram kg-1 of fentanyl and Group II received 5 microgram kg-1 of fentanyl. After 5 minutes of administration of either one of these all patients were induced with etomidate at a dose of 0.3 mg kg-1. The parameters monitored are Pain on injection, Myoclonus, Apnoea, Heart rate, Systemic blood pressure, Post operative nausea and vomiting. We found that in Group I, no patient become apnoeic while in group II three patients become apnoeic after administration of fentanyl. Also with increasing dose of fentanyl, there was a decreasing incidence of pain on injection, myoclonus. But at the same time there was increasing incidence of post operative nausea and vomiting in group II. We also found that the increase of heart rate and blood pressure, during induction-intubation sequence with etomidate is significantly lower in group II with increasing dose of fentanyl. Therefore we conclude that at a dose of 5µg/kg of fentanyl, there is reduction of side effects of etomidate and also there is attenuation of hemodynamic response to intubation in patients undergoing elective surgeries under general anaesthesia with etomidate as induction agent