Document Detail


Thoracolumbar epidural anaesthesia blocks the circulatory response to laryngoscopy and intubation.
MedLine Citation:
PMID:  3630599     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laryngoscopy and endotracheal intubation cause a stress reaction resulting in an increase in heart rate and systemic blood pressure. This haemodynamic response is considered to be due to a sympathetic discharge caused by stimulation of the upper respiratory tract. This stress reaction during laryngoscopy and endotracheal intubation was studied in patients with total thoracolumbar epidural anaesthesia (EDA). Nine patients with thoracolumbar EDA including at least the segments T1 to L2 were compared to seven patients without EDA during induction of general anaesthesia. The epidural anaesthesia was achieved with 2% mepivacaine with adrenaline. General anaesthesia was induced with thiopentone 4-5 mg/kg followed by 100 mg suxamethonium. The highest blood pressure value during the first 2 min after intubation was compared to the value immediately before intubation. The epidural anaesthesia caused a reduction of the mean arterial blood pressure (MAP) by 25%, and a reduction of the heart rate (HR) by 7%, but neither the induction with thiopentone nor the laryngoscopy and intubation caused any changes in mean arterial blood pressure or heart rate. However, in the control group MAP increased 29% and HR 16% following intubation. Thus, the T1-L2 epidural anaesthesia with 2% mepivacaine with adrenaline blocked the blood pressure reaction to laryngoscopy and intubation, and consequently the efferent sympathetic nervous system was completely blocked.
Authors:
M Wattwil; A Sundberg; J Olsson; S Nordström
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  31     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1987 Aug 
Date Detail:
Created Date:  1987-09-29     Completed Date:  1987-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  529-31     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, Epidural*
Female
Hemodynamics / drug effects*
Humans
Intubation, Intratracheal*
Laryngoscopy*
Male
Middle Aged
Neurons, Afferent / drug effects
Preanesthetic Medication
Succinylcholine
Thiopental
Chemical
Reg. No./Substance:
306-40-1/Succinylcholine; 76-75-5/Thiopental

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


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