The Effect of Different Dosage of Propofol on Cardiovascular Responses to Tracheal Intubation in Hypertensive Patients.

Choi,  Young Seok; Lee,  Won Gi; Oh,  In Young; Son,  Ji Young; Lee,  Mi Kyung; Lim,  Sang Ho; Yoon,  Suk Min

doi:1996.31.5.588

Korean Journal of Anesthesiology 1996;31(5):588-593.
DOI: https://doi.org/10.4097/kjae.1996.31.5.588

Young Seok Choi, Won Gi Lee, In Young Oh, Ji Young Son, Mi Kyung Lee, Sang Ho Lim, Suk Min Yoon

Department of Anesthesiology, College of Medicine, University, Seoul, Korea.

Abstract

BACKGROUND
Laryngoscopy and endotracheal intubation are potent stimuli that increase heart rate and blood pressure. Especially, hypertensive patients are more prone to have significant increase in heart rate and blood pressure and cardiac complications such as arrythmia, myocardial ischemia and infarction can lead to fatal situation. This study was designed to evaluate the effectiveness of different dosage of propofol on cardiovascular responses to tracheal intubation in hypertensive patients.
METHODS
Sixty hypertensive patients, ASA PS 1 or 2, scheduled for elective surgery were selected randomly. They were divided into three groups(Group 1: propofol 2.0 mg/kg, Group 2: propofol 2.5 mg/kg, Group 3: propofol 3.0 mg/kg, n=20 in each group). Induction of Anesthesia was started with propofol 2.0 mg/kg(Group 1), 2.5 mg/kg(Group 2), 3.0 mg/kg(Group 3) and succinylcholine(1 mg/kg). After tracheal intubation, pancuronium bromide 0.08 mg/kg was injected, 50 % nitrous oxide in oxygen and 2 % enflurane were inhaled. Using noninvasive automatic blood pressure monitor(CRITIKON DINAMAP TM 1846SX, USA), blood pressure(systolic, diastolic, and mean arterial pressure) and heart rate were measured at 4 points; 1) as the control value, on arrival to operating room, 2) 1 minute after tracheal intubation, 3) 3 minutes after intubation, 4) 5 minutes after intubation.
RESULTS
In group 3, systolic, diastolic pressure and mean arterial pressure at 1 minutes, 3 minutes, 5 minutes after intubation were less increased than group 1, 2 and blood pressure response was more effectively blunted than heart rate response CONCLUSIONS: we suggested that 3.0 mg/kg of propofol for the induction of anesthesia could blunt hemodynamic changes caused by laryngoscopy and endotracheal intubation in hypertensive patients, but we had to give attention to the side effect until postoperative period.

Key Words: Anesthetics; intravenous Propofol; Anesthetic techniques endotracheal intubation; Blood pressure; Heart heart rate