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Korean Journal of Anesthesiology 2005;49(2):136-141.
DOI: https://doi.org/10.4097/kjae.2005.49.2.136   
The Effects of Alfentanil and a Combination of Alfentanil and Esmolol on Hemodynamic Responses after Endotracheal Intubation in Hypertensive Patients.
Hyun Kang, In Goo Lee, Choon Kyu Cho, Chong Hwa Baek, Jung Won Park, Yong Hun Jung, Young Cheol Woo, Jin Yun Kim, Gill Hoi Koo, Sun Gyoo Park
1Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. jyk5399@yahoo.co.kr
2Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
Abstract
BACKGROUND
This study was desined to determine the efficacy and clincial usefulness of alfentanil and a combined use of alfentanil and esmolol for blunting hemodynamic responses after tracheal intubation in hypertensive patients who needed a rapid sequence induction.
METHODS
Group 1 received alfentanil 15microgram/kg and group 2 received alfentanil 15microgram/kg and esmolol 1 mg/kg intravenously. Thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg were used for the induction of anesthesia. Changes in blood pressure and herat rate were measured during intubation and induction of anesthesia with enflurane-N2O-O2 and vecuronium. Rate pressure products (RPP) was calculated and the frequencies of hypertension, hypotension, tachycardia, bradycardia were measured.
RESULTS
In group 1, systolic blood pressure increased significantly at 1, 2 minute and decreased significantly at 4, 5, 10, 15 minute compared to base, and diastolic blood pressure increased significantly at 1 minute and decreased significantly at 4, 5, 10 minute. Heart rate increased significantly at 1, 2 minute. In group 2, systolic blood pressure decrease significantly at 3, 4, 5 minute after tracheal intubation compared to base, and diastolic blood pressure increased at 1 minute and decreased at 4, 5, 10, 15 minute. HR did not change significantly (P < 0.05).
CONCLUSION
In treated hypertensive patients, the use of a combination of alfentanil 15/kg and esmolol 1 mg/kg is a useful method to attenuate hemodynamic responses after endotracheal intubation and especially for rapid sequence induction.
Key Words: alfentanil; esmolol; hypertension; intubation


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