Alfentanil as an Anesthetic Induction Agent-A Comparison with Thiopental-Lidocaine

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Abstract
Alfentanil (0.175 mg/kg) and a combination of thiopental (3–4 mg/kg) and lidocaine (1.5 mg/kg) during anesthetic induction were compared. Each was administered rapidly to eight patients with cardiovascular disease (average age, 64 yr), followed by succinylcholine (1.5 mg/kg) for laryngoscopy and intubation. Chest wall rigidity or flexor spasm of arm and jaw were seen transiently in 7 of 8 patients receiving alfentanil. Both drugs led to decreases in mean arterial pressure averaging 31 mm Hg (P < 0.01). In patients given thiopental-lidocaine, intubation led to a 28 mm Hg (P < 0.01) increase over control in arterial pressure and a 10 beats-min-1 increase in heart rate (P < 0.01). In patients given alfentanil, after intubation arterial pressure returned to levels no different from control and the heart rate remained stable. Five of the patients given alfentanil required a single dose ofnaloxone (0.08–0.15 mg) to achieve a PCO2 less than 50 ton at the end of surgery. Rapidly administered alfentanil blunted the cardiovascular response to intubation but decreased arterial pressure as much as thiopental-lidocaine.

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