Abstract
Eighty patients, ASA physical status II-IV, scheduled for noncardiac surgery, were randomly assigned in a double-blind, placebo-controlled manner to receive a preintubation dose of either placebo, 200 mg lidocaine, 200 μg fentanyl, or 150 mg esmolol. Induction of anesthesia was accomplished with 4-6 mg/kg thiopental IV followed immediately by the study drug; 1-1.5 mg/kg succinylcholine was given at minute 1. Laryngoscopy and intubation were performed at minute 2 with anesthesia thereafter maintained with 1 MAC (±10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 10 min. Heart rate was recorded every 15 s and blood pressure every minute from induction until 10 min after intubation. Maximum percent increases in heart rate (mean ± SE) during and after intubation were similar in the placebo (44% ± 6%), lidocaine (51% ± 10%), and fentanyl (37% ± 5%) groups, but lower in the esmolol (18% ± 5%) group (P < 0.05). Maximum systolic blood pressure percent increases were lower in the lidocaine (20% ± 6%), fentanyl (12% ± 3%), and esmolol (19% ± 4%) groups than in the placebo (36% ± 5%) group (P < 0.05), but not different from each other (P > 0.05). Only esmolol provided consistent and reliable protection against increases in both heart rate and systolic blood pressure accompanying laryngoscopy and intubation.
| Original language | English |
|---|---|
| Pages (from-to) | 482-486 |
| Number of pages | 5 |
| Journal | Anesthesia and Analgesia |
| Volume | 72 |
| Issue number | 4 |
| State | Published - Jan 1 1991 |
| Externally published | Yes |
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Keywords
- analgesics, fentanyl
- anesthetics, local - lidocaine
- intubation, tracheal - prevention of vascular responses
- sympathetic nervous system, pharmacology - esmolol
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Which drug prevents tachycardia and hypertension associated with tracheal intubation : Lidocaine, fentanyl, or esmolol? / Helfman, S. M.; Gold, M. I.; DeLisser, E. A.; Herrington, C. A.
In: Anesthesia and Analgesia, Vol. 72, No. 4, 01.01.1991, p. 482-486.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Which drug prevents tachycardia and hypertension associated with tracheal intubation
T2 - Lidocaine, fentanyl, or esmolol?
AU - Helfman, S. M.
AU - Gold, M. I.
AU - DeLisser, E. A.
AU - Herrington, C. A.
PY - 1991/1/1
Y1 - 1991/1/1
N2 - Eighty patients, ASA physical status II-IV, scheduled for noncardiac surgery, were randomly assigned in a double-blind, placebo-controlled manner to receive a preintubation dose of either placebo, 200 mg lidocaine, 200 μg fentanyl, or 150 mg esmolol. Induction of anesthesia was accomplished with 4-6 mg/kg thiopental IV followed immediately by the study drug; 1-1.5 mg/kg succinylcholine was given at minute 1. Laryngoscopy and intubation were performed at minute 2 with anesthesia thereafter maintained with 1 MAC (±10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 10 min. Heart rate was recorded every 15 s and blood pressure every minute from induction until 10 min after intubation. Maximum percent increases in heart rate (mean ± SE) during and after intubation were similar in the placebo (44% ± 6%), lidocaine (51% ± 10%), and fentanyl (37% ± 5%) groups, but lower in the esmolol (18% ± 5%) group (P < 0.05). Maximum systolic blood pressure percent increases were lower in the lidocaine (20% ± 6%), fentanyl (12% ± 3%), and esmolol (19% ± 4%) groups than in the placebo (36% ± 5%) group (P < 0.05), but not different from each other (P > 0.05). Only esmolol provided consistent and reliable protection against increases in both heart rate and systolic blood pressure accompanying laryngoscopy and intubation.
AB - Eighty patients, ASA physical status II-IV, scheduled for noncardiac surgery, were randomly assigned in a double-blind, placebo-controlled manner to receive a preintubation dose of either placebo, 200 mg lidocaine, 200 μg fentanyl, or 150 mg esmolol. Induction of anesthesia was accomplished with 4-6 mg/kg thiopental IV followed immediately by the study drug; 1-1.5 mg/kg succinylcholine was given at minute 1. Laryngoscopy and intubation were performed at minute 2 with anesthesia thereafter maintained with 1 MAC (±10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 10 min. Heart rate was recorded every 15 s and blood pressure every minute from induction until 10 min after intubation. Maximum percent increases in heart rate (mean ± SE) during and after intubation were similar in the placebo (44% ± 6%), lidocaine (51% ± 10%), and fentanyl (37% ± 5%) groups, but lower in the esmolol (18% ± 5%) group (P < 0.05). Maximum systolic blood pressure percent increases were lower in the lidocaine (20% ± 6%), fentanyl (12% ± 3%), and esmolol (19% ± 4%) groups than in the placebo (36% ± 5%) group (P < 0.05), but not different from each other (P > 0.05). Only esmolol provided consistent and reliable protection against increases in both heart rate and systolic blood pressure accompanying laryngoscopy and intubation.
KW - analgesics, fentanyl
KW - anesthetics, local - lidocaine
KW - intubation, tracheal - prevention of vascular responses
KW - sympathetic nervous system, pharmacology - esmolol
UR - http://www.scopus.com/inward/record.url?scp=0025729843&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025729843&partnerID=8YFLogxK
M3 - Article
C2 - 1672488
AN - SCOPUS:0025729843
VL - 72
SP - 482
EP - 486
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 4
ER -