Document Detail


Effects of esmolol, lidocaine and fentanyl on haemodynamic responses to endotracheal intubation: a comparative study.
MedLine Citation:
PMID:  17358099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Predicting the haemodynamic changes that may result in myocardial ischaemia for patients undergoing laryngoscopy and tracheal intubation will help to avoid events that trigger ischaemia and allow immediate treatment. The objective of this study was to compare the effects of esmolol with those of lidocaine (lignocaine) and fentanyl on prevention of tachycardia and hypertension caused by endotracheal intubation. METHODS: This was a prospective, randomised, double-blind study. The study was conducted at the Adnan Menderes University Hospital in Aydin, Turkey and involved 120 patients of American Society of Anesthesiologists physical status I or II aged 20-50 years. The patients were randomised into four equal groups. The control group (group C) received dextrose 5% 5 mL, the esmolol group (group E) received esmolol 1.5 mg/kg, the fentanyl group (group F) received fentanyl 1 microg/kg and the lidocaine group (group L) received lidocaine 1.5 mg/kg 2 minutes before endotracheal intubation. Heart rate (HR), mean arterial pressure (MAP) and rate-pressure product (RPP) were recorded before and after induction of anaesthesia, immediately after intubation, and 1, 3, 5, 7 and 10 minutes after intubation. RESULTS: Compared with control, HR decreased significantly in group E after induction, immediately after intubation and 1 minute after intubation (p < 0.0083). In group F there was an increase in MAP immediately after intubation, but the increase was less than in other groups. Compared with control, RPP decreased significantly in groups E and F after induction, immediately after intubation and 1 minute after intubation (p < 0.0083). RPP was significantly lower in group E than in controls and group L 3 minutes after intubation (p < 0.0083), and it was significantly lower in group F than in controls 10 minutes after intubation (p < 0.0083). CONCLUSION: It can be concluded that administration of esmolol 1.5 mg/kg 2 minutes before intubation prevents tachycardia and an increase in RPP caused by laryngoscopy and tracheal intubation, and can be beneficial when administered before laryngoscopy and tracheal intubation in patients with tachycardia.
Authors:
Bakiye Ugur; Mustafa Ogurlu; Erdal Gezer; Osman Nuri Aydin; Feray Gürsoy
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical drug investigation     Volume:  27     ISSN:  1173-2563     ISO Abbreviation:  Clin Drug Investig     Publication Date:  2007  
Date Detail:
Created Date:  2007-03-15     Completed Date:  2007-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504817     Medline TA:  Clin Drug Investig     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  269-77     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Reanimation, Adnan Menderes University Faculty of Medicine, Aydin, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects*
Double-Blind Method
Fentanyl / pharmacology*
Heart Rate / drug effects*
Humans
Intubation, Intratracheal*
Lidocaine / pharmacology*
Propanolamines / pharmacology*
Chemical
Reg. No./Substance:
0/Propanolamines; 137-58-6/Lidocaine; 437-38-7/Fentanyl; 84057-94-3/esmolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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