The effect of ketamine and fentanyl on haemodynamics during intubation in pre‐hospital and retrieval medicine
Authors' conclusion
The addition of fentanyl to ketamine for RSI was not associated with an alteration of the odds of post-induction haemodynamic stability, although the doses used were low.
Study context
- Population
- Patients undergoing rapid sequence intubation (RSI) with ketamine ± fentanyl in pre-hospital and retrieval medicine (PHARM), 2015–2019804 analysed
- Participants
- 876 patients
- Exposure
- Ketamine + fentanyl vs ketamine alone for RSI
- Ketamine + fentanyln = 135
- Ketamine alonen = 669reference
- Outcome
- Proportion with SBP outside a pre-specified target range, adjusted for baseline abnormality
- Follow-up
- Within 10 min of anaesthetic induction
Methodological detailsmultivariable logistic regression
- Multivariable logistic regression
Main finding
As reported in the abstract
SBP outside pre-specified target range within 10 min of induction, adjusted for baseline abnormality
Fentanyl use not associated with a change in odds of meeting the primary outcome (OR, 95% CI)
OR 1.08; 95% CI 0.72-1.60
Observational data: associations, not effects.
Further findings
Frequency of fentanyl use with ketamine
- Received ketamine alone
- 669 (83%, 95% CI 80%-86%)
- Received both fentanyl and ketamine
- 135 (17%, 95% CI 14%-20%)
Fentanyl dose
- Median fentanyl dose (IQR)
- 1.1 mcg/kg (IQR 0.75-1.5 mcg/kg)
Becoming hypertensive
- Fentanyl use not associated with a change in odds of becoming hypertensive (OR, 95% CI)
- OR 1.35; 95% CI 0.88-2.07
Becoming hypotensive
- Fentanyl use not associated with a change in odds of becoming hypotensive (OR, 95% CI)
- OR 0.76; 95% CI 0.47-1.21
Systolic blood pressure (SBP) at induction and SBP after intubation
- SBP at induction consistently associated with SBP after intubation in multivariable logistic regression
Original publication
The effect of ketamine and fentanyl on haemodynamics during intubation in pre‐hospital and retrieval medicine. Acta Anaesthesiol Scand. Published 13 December 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →