Low Dose Sufentanil with Esmolol in Reducing the Increase of Heart Rate and Blood Pressure after Endotracheal Intubation. |
Sang Mi Han, Chul Ho Shin, Doo Sik Kim, Se Hun Park, Sie Jeong Ryu, Kyung Han Kim, Tae Ho Jang, Se Hwan Kim |
Department of Anesthesiology, College of Medicine, Kosin University, Pusan, Korea. |
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Abstract |
BACKGROUND Laryngoscopy and tracheal intubation usually induce tachycardia and hypertension. Various drugs including esmolol and fentanyl have been employed to reduce the cardiovascular response accompanying laryngoscopy and intubation. The purpose of this study is to assess the efficacy of low dose sufentanil with esmolol in reducing hypertension and tachycardia induced by endotracheal intubation. METHODS Forty surgical patients from Kosin medical hospital were randomly assigned to receive either normal saline (n = 20, control group) or sufentanil (0.3 microgram/kg) with esmolol (1 mg/kg) (n = 20, S & E group) before anesthetic induction. Anesthesia was induced intravenously with pentothal sodium 4 mg/kg followed by endotracheal intubation after succinylcholine 1 mg/kg. Changes in systolic blood pressure, mean arterial blood pressure, diastolic blood pressure, heart rate, and SpO2 (arterial oxygen saturation by pulse oximeter) were measured at 30 seconds, 1 minute, 2 minutes, 3 minutes, 4 minutes and 5 minutes following intubation. The values of each group were compared with preinduction baseline values, and the S&E group was compared with the control group. Data were analyzed for statistical significance using repeated measures of ANOVA and chi-square test. RESULTS In the S&E group, the systolic and mean arterial pressures at 30 seconds and 1 minute, and diastolic blood pressure at 30 seconds after intubation were significantly lower than the values of the control group (P < 0.01). The heart rates at 30 seconds, 1 minute were significantly lower compared to the control group (P < 0.01 and P < 0.05, respectively). CONCLUSIONS The results suggest that pretreatment of low dose sufentanil with esmolol is effective to reduce the elevation of blood pressure and heart rate due to laryngoscopy and intubation. |
Key Words:
Anesthetics, intravenous: esmolol; sufentanil; Intubation; Monitoring: blood pressure; heart rate |
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