Alfentanil versus fentanyl for emergency department rapid sequence induction with ketamine: A-FAKT, a pilot randomized trial.
The American journal of emergency medicine October 1, 2024 Yichen Zhang, Matthew Miller, Alexander Buttfield et al. 2 citations
In a pilot randomized controlled trial at three Australian emergency departments, alfentanil and fentanyl produced similar effects on blood pressure and heart rate when given with ketamine and rocuronium for rapid sequence induction. Among 61 patients, 58% in the alfentanil group and 50% in the fentanyl group had at least one post-induction systolic blood pressure outside 100–160 mmHg, a difference of 8% with a wide confidence interval (−17% to 33%). Rates of hypertension, hypotension, hypoxia, first-pass intubation success, and 30-day mortality were also similar between groups. The findings suggest both opioids are comparable adjuncts for hemodynamic control during emergency intubation.