Induction strategies for preventing hemodynamic changes after intubation in non-cardiac surgery patients: a network meta-analysis of randomized controlled trials

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Source: Frontiers Medicine

Original: https://www.frontiersin.org/articles/10.3389/fmed.2026.1694700...

Published: 2026-01-22T00:00:00Z

A network meta-analysis investigated induction strategies to prevent hemodynamic changes after tracheal intubation in patients undergoing non-cardiac surgery. It included 10 randomized controlled trials with 791 patients. The main indicators were changes in mean arterial pressure (ΔMAP) and heart rate (ΔHR). The oxycodone-propofol-lidocaine combination (87.4%) was most effective in controlling MAP fluctuations, followed by fentanyl-propofol-dexmedetomidine (82.9%) and fentanyl-propofol-clonidine (81.6%). Fentanyl-propofol-dexmedetomidine (94.8%), followed by fentanyl-propofol-lidocaine (epidural) (83.3%) and fentanyl-propofol-remifentanil (79.1%) were the best in controlling HR fluctuations. The study recommends further randomized controlled trials to confirm the results and optimal dosing. Registration: CRD42024591333.