| Effect of Preinduction Atropine on the Cardiovascular Response to Anesthesia with Propofol-Fentanyl. |
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Kyung Ream Han, Guie Yong Lee |
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Department of Anesthesiology, College of Medicine, Ewha Womans University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Induction of anesthesia with propofol is associated with decrease in blood pressure, but changes of heart rates are minimal. However the combination of two centrally acting vagotonic agents, propofol and fentanyl, decreased heart rates on induction, with concomitant decreases in arterial pressure. Thus we evaluated the effect of atropine on these hemodynamic changes.
METHODS
Patients were randomly allocated to three group.
Group 1 was given no atropine premedication. In group 2, premedication with 0.01 mg/kg of atropine was administered intramusculary about one hour before anesthetic induction.
In group 3, pretreatment with 0.01 mg/kg of atropine was administered intravenously about 4 minutes before anesthetic induction. Anesthesia was induced with 1 microgram/kg of fentanyl, 2~2.5 mg/kg of propofol and 0.1 mg/kg of vecuronium and maintained with nitrous oxide, oxygen and enflurane. Heart rate and blood pressure were measured 1, 5 min before induction and 1, 2, 3, 5, 7, 9 min after induction.
RESULTS
Heart rates are increased significantly(P<0.001) during the 3 minutes before induction in patients given atropine intravenously and remained significantly higher(P<0.05) during early maintenance of anesthesia than in patients receiving no premedication of atropine. The systolic and diastolic blood pressure weren't changed significantly between the three groups.
CONCLUSIONS
Pretreatment of atropine intravenously before induction of anesthesia with propofol and fentanyl attenuates the decreasing the heart rates but does not affect the blood pressure before intubation. |
| Key Words:
Anesthetics; ntravenous propofol; fentanyl; Pretretment atropine |
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