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Opioids are sometimes given as pretreatment agents to mitigate the catecholamine release associated with laryngoscopy, although benefit from this practice has not been proven. Fentanyl is an opioid often chosen for its lack of histamine-releasing properties and its short duration. Nevertheless, its lessening of adrenergic tone may predispose recipients to hypotension. Investigators conducted a secondary analysis using a database of intubations in 14 Japanese emergency departments to determine whether pretreatment with fentanyl was associated with postintubation hypotension, defined as a systolic pressure ≤90 mm Hg, during rapid sequence intubation.
Among 1263 patients without baseline hypotension, 37% had pretreatment with fentanyl, and the …