Optimal Dose of Intravenous Oxycodone for Endotracheal Intubation
Condition: Intubation Complication; Blood Pressure
Study type: Interventional
Phase: Phase 4

Summary: 
      Intravenous form of oxycodone is recently used for the adjunct of anesthetic agents to avoid
      adverse effects of the stimulation of endotracheal intubation. The potency ratio of oxycodone
      to fentanyl is not absolutely defined. The aim of this study was to assess the optimal dose
      of intravenous oxycodone for attenuation of hemodynamic responses to laryngoscopy and
      endotracheal intubation.

      A prospective, randomized, double-blind study was conducted. Ninety one patients were
      randomly divided into 5 group based on the dose of oxycodone; 0, 0.05, 0.1, 0.15, 0.2 mg/kg.
      After giving each assigned dose of intravenous oxycodone, anesthesia was induced with
      thiopental and rocuronium. Heart rate (HR) and blood pressure (BP) was collected at baseline,
      before intubation, 1, 2, 3 minutes after intubation. The change of BP was calculated by
      (highest BP after intubation - baseline BP)/baseline BP.
    

Detailed description: 
      Endotracheal intubation is almost always associated with increase of catecholamine and
      arterial blood pressure. To prevent the responses to laryngoscopy and tracheal intubation,
      adjuvant use of opioid to sedative drugs during anesthetic induction phase are common.
      Intravenous form of oxycodone is recently used for the adjunct of anesthetic agents to avoid
      adverse effects of the stimulation of endotracheal intubation. However, The potency ratio of
      oxycodone to fentanyl is not absolutely defined. Therefore, the investigators aimed to assess
      the optimal dose of intravenous oxycodone for attenuation of hemodynamic responses to
      laryngoscopy and endotracheal intubation.

      The patients were randomly divided into five different groups based on the dose of oxycodone;
      0. 0.05, 0.1, 0.15, 0.2 mg/kg. The drug was prepared by a person who is not participating the
      anesthetic management and surgery of the patient. In five groups, the drug was mixed with
      normal saline which makes the total drug volume to be 10 ml. After monitoring was started
      including ECG, noninvasive blood pressure, and pulse oximetry, the anesthesiologist who has
      no information about the drug give the drug when starting induction of anesthesia. Thiopental
      4-5 mg/kg and rocuronium 0.6-0.9 mg/kg was given subsequently. Manual ventilation was done
      with sevoflurane 3-5 volume% for 2-3 minutes and tracheal intubation was done. Maintenance of
      anesthesia was done with 50% O2 with nitrous oxide and sevoflurane. Mechanical ventilation
      was done with tidal volume 10 ml/kg and respiratory rate 12 /min. The baseline hemodynamic
      data including heart rate and blood pressure was recorded and those before intubation, 1,2,3
      minutes after intubation were obtained. The discrepancies between the highest and baseline,
      the lowest blood pressure and heart rate and baseline were used to make out the proportion of
      hemodynamic changes. This proportion of the hemodynamic changes were compared in five groups.
      In addition, the use of vasopressor was also recorded and the frequency and the cumulative
      dose was compared among the groups.
    

Intervention name(s): saline; 0.05 mg/kg of oxycodone; 0.1 mg/kg of oxycodone; 0.15 mg/kg of oxycodone; 0.2 mg/kg of oxycodone
Intervention type(s): Drug; Drug; Drug; Drug; Drug
Intervention description(s): different dosage of IV oxycodone was given before intubation; different dosage of IV oxycodone was given before intubation; different dosage of IV oxycodone was given before intubation; different dosage of IV oxycodone was given before intubation; different dosage of IV oxycodone was given before intubation
Other intervention name(s): OxyNorm; OxyNorm; OxyNorm; OxyNorm
Intervention MeSH terms: Oxycodone
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: dosage of oxycodone during intubation