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. |
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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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