Background: Both tracheal intubation and extubation are associated with dangerous effects such as hypertension, tachycardia, myocardial ischemia and arrhythmias. The aim was to evaluate pre-extubation two different doses of fentanyl on hemodynamic stabilization and delayed recovery in mastectomy.
Methods: The randomized controlled double-blind study was conducted on 126 patients aged 16-60 years, with controlled hypertension, receiving chemotherapy before surgery and underwent mastectomy for breast cancer. Patients were randomly allocated into 3 equal groups. Before extubation, patients received 10 ml saline in group (C), 1 mic/kg fentanyl in group F1: and 2 mic/kg fentanyl in group F2. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at T1 (after maintenance of anesthesia), T2 (after giving the test drug), T3 (immediately after extubation), T4 (5 min. after extubation) and T5 (15 min after extubation).
Results: MAP was significantly lower in fentanyl groups compared to group C at T2 and T3 without significant deference between fentanyl groups. HR was significantly lower in fentanyl groups compared to group C and in group F2 compared to group F1 at T3, T4 and T5. Time of extubation was significantly prolonged in group F2 compared to group F1 and group C without a significant difference between group F1 and group C.
Conclusions: Pre-extubation fentanyl 1mic/kg blunted cardiovascular responses to extubation without respiratory depression or prolonged recovery. Pre-extubation fentanyl 2 mic/kg provide more control in HR but with delay in the extubation time compared to 1mic/kg of fentanyl.
Key words: Pre-Extubation, Fentanyl, Mastectomy, Hemodynamics, Recovery
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