A Randomized Comparative Study of Fentanyl 2 mcg/kg versus 4 mcg/kg in Attenuating the Hemodynamic Stress Response during Laryngoscopy and Endotracheal Intubation in Patients undergoing Intracranial Surgery

Laryngoscopy and tracheal intubation are known to cause significant sympathetic stimulation, resulting in transient increases in heart rate and blood pressure. These hemodynamic responses can be particularly dangerous in patients undergoing intracranial surgery due to the risk of elevated intracranial pressure and compromised cerebral perfusion. Fentanyl, a potent opioid analgesic, is commonly used to blunt these responses.

This study aims to compare the efficacy of two different fentanyl dosing regimens—2 mcg/kg versus 4 mcg/kg—in attenuating the hemodynamic changes associated with direct laryngoscopy and intubation in patients undergoing intracranial surgery. The primary outcomes include changes in heart rate, systolic and diastolic blood pressure, and mean arterial pressure during and after laryngoscopy. The study also evaluates the safety profile of each dose in this sensitive patient population.