ATTENUATION OF INTUBATION-INDUCED CARDIOVASCULAR RESPONSE WITH THREE DIFFERENT PRETREATMENT DRUGS : Anesthesia & Analgesia

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Abstracts of Posters; Presented at the International Anesthesia Research Society; 73rd Clinical and Scientific Congress; Los Angeles, CA; March 12-16, 1999: Pharmacology

ATTENUATION OF INTUBATION-INDUCED CARDIOVASCULAR RESPONSE WITH THREE DIFFERENT PRETREATMENT DRUGS

Mok, M.S. MD; Wu, C.C. MD; Han, S.R. MD

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Anesthesia & Analgesia 88(2S):p 367S, February 1999. | DOI: 10.1097/00000539-199902001-00364
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Abstract S367

The present study was undertaken to evaluate the effect of pretreatment with 3 different cardiovascular depressants on attenuating the cardiovascular response to intubation.

METHOD: Eighty adult patients of ASA class I-II without history of cardiovascular disease, who were scheduled for non-cardiac surgeries, were assigned to 4 equal groups of 20 each by a randomized, double-blind design to receive pre-intubation dose of either saline placebo, esmolol 60 mg, magnesium sulfate (MgSO4) 3.6 gm or nicardipine 2 mg. After baseline heart rate and blood pressure readings, the study drug was given I.V. followed immediately with induction dose of thiamylal 5 mg/kg. Succinylcholine 1.5 mg/kg was given at 1 minute later and readings of HR, BP were taken at 1 minute after succinylcholine after which laryngoscopy and intubation were done. Anesthesia was maintained with 1% isoflurane in 50% N20 and 50% O2, and HR, BP readings were recorded every minute for 8 minutes after Intubation.

RESULT: Maximal increase (mean value) in heart rate after intubation was 19.5% in placebo, 21% in esmolol, 12% in MgSO4 and 48% in nicardipine group respectively. Maximal systolic BP increase (mean value) was 24.5% in placebo, 24% in esmolol, 15.6% in MgSO4 and 13.3% in nicardipine group. Esmolol and MgSO4 did not produce significant changes in heart rate, systolic BP or diastolic BP compared to placebo. Nicardipine, on the other hand, caused a significant reduction of systolic and diastolic BP at 1 and 2 minutes after drug administration and a significantly less increase in BP compared to that of placebo. However, there was a significant increase in heart rate associated with nicardipine after drug and after intubation.

DISCUSSION: Our study showed that none of the three drugs tested at the dose recommended by the manufacturer provided satisfactory obtunding effect on the intubation-induced cardiovascular response. Perhaps a combination of the above drugs would produce a better result, which warrants further studies.

© 1999 International Anesthesia Research Society