44699
document
Attenuation of hemodynamic responses to laryngoscopy and tracheal intubation during rapid sequence induction : remifentanil vs. lidocaine with esmolol . AIM This study was designed to compare the effectiveness of remifentanil vs. a lidocaine-esmolol combination in blunting the hemodynamic response to laryngoscopy and intubation during rapid sequence induction using thiopental and rocuronium in normotensive patients . METHODS Sixty-six patients with American Society of Anesthesiologists ( ASA ) physical status class I who required tracheal intubation for elective surgery were randomly assigned to one of two groups . Group R received 0.9 % saline 10 ml and remifentanil 1 microg/kg . Group LE received lidocaine 1.5 mg/kg and esmolol 1.0 mg/kg . Anesthesia was induced with thiopental sodium 5 mg/kg , followed by rocuronium 1.0 mg/kg . Mean arterial pressure and heart rate were recorded at baseline , after induction , immediately after intubation and every minute for five minutes after intubation . RESULTS Changes in mean arterial pressure over time between the two groups were significantly different ( P < 0.0001 ) . The maximum pressor response was observed immediately after intubation , at which time the mean arterial pressure change from baseline in group LE ( 29.7 % ) ( 95 % confidence interval [ CI ] : 116.1 , 121.9 ) was higher than that in group R ( 4.4 % ) ( 95 % CI : 92.9 , 98.5 ) ( P < 0.0001 ) . Two patients in group R and 15 patients in group LE developed hypertension ( odds ratio [ OR ] : 0.064 ) ( P < 0.001 ) . Changes in heart rate over time between the two groups were not significantly different ( P=0.465 ) . CONCLUSION The results of this study show that remifentanil 1 mg/kg is more effective than the combination of lidocaine 1.5 mg/kg and esmolol 1 mg/kg for attenuating the hemodynamic responses to rapid sequence intubation .
44700
Intervention_Pharmacological
remifentanil
44701
Intervention_Pharmacological
lidocaine with esmolol
44702
Intervention_Pharmacological
remifentanil
44703
Intervention_Pharmacological
lidocaine-esmolol
44704
Intervention_Pharmacological
0.9 % saline 10 ml and remifentanil 1 microg/kg .
44705
Intervention_Pharmacological
lidocaine 1.5 mg/kg and esmolol 1.0 mg/kg
44706
Intervention_Pharmacological
thiopental sodium
44707
Intervention_Pharmacological
rocuronium
44708
Intervention_Pharmacological
remifentanil
44709
Intervention_Pharmacological
lidocaine
44710
Intervention_Pharmacological
esmolol
44711
Outcome_Physical
hemodynamic response
44712
Outcome_Physical
Mean arterial pressure and heart rate
44713
Outcome_Physical
mean arterial pressure over time
44714
Outcome_Physical
maximum pressor response
44715
Outcome_Physical
mean arterial pressure change
44716
Outcome_Physical
hypertension
44717
Outcome_Physical
heart rate over time
44718
Outcome_Physical
hemodynamic responses
44719
Participant_Condition
normotensive
44720
Participant_Sample-size
Sixty-six
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Participant_Condition
American Society of Anesthesiologists ( ASA ) physical status class I who required tracheal intubation for elective surgery