Effects of Co-administration of Fentanyl and Nitroglycerin on Hemodynamic Responses During Intubation and Extubation: A Randomized Clinical Trial.

Purpose: This study was conducted with the aim of investigating the effects of simultaneous administration of fentanyl and nitroglycerine on hemodynamic responses.

Design: This randomized controlled trial was conducted with 50 patients undergoing elective inguinal hernia surgery.

Methods: Patients were randomly divided into two groups. In one group, fentanyl (F) was administered 5 minutes before intubation and extubation. In the other group, in addition to F, sublingual nitroglycerine spray was administered 2 minutes before intubation and extubation. Systolic, diastolic, and mean blood pressure and heart rate were measured before, immediately after, and at 1, 3, and 5 minutes after both procedures.

Findings: Systolic, diastolic, and mean blood pressure and heart rate were significantly lower in the group receiving fentanyl and nitroglycerine than in the group receiving fentanyl alone. In both groups, a reduction in hemodynamic variables was observed immediately after both procedures, up to 5 minutes later, but it was significantly reduced in the group receiving simultaneous administration of the two drugs.

Conclusions: Co-administration of nitroglycerine and fentanyl significantly weakened the hemodynamic responses and reflexes induced by intubation and extubation during the anesthesia process. Preventing these unwanted complications can lead to safer anesthesia for susceptible patients.