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KMID : 0356919940270111601
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Korean Journal of Anesthesiology
1994 Volume.27 No. 11 p.1601 ~ p.1610
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Cardiovacscular effects of esmolol, lidocaine and fentanyl on endotracheal intubation in hypertensive patient
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이상곤
여상임/민병우/박대팔
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Abstract
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This study is designed to compare the effectiveness of single-bolus lidocaine, fentanyl and esmolol at the tiime of postintubation to blunt the hemodynamic intubation response in hypertensive patients.
Sixty mildly hypertensive patients, scheduled for elective surgery, were randomly assigned in a double blind to receive a preintubation dose: in the first group (Group A), 20 patients received 1.5mg/kg lidocaine; in the second group (Group B),
another
20 patients received 3μg/kg fentanyl; and in the third group (Group C), another 20 patients received 100mg esmolol.
Within the above mentioned framework, this study obtained the following results: Systolic arterial pressure (SAP), heart rate (HR) and rate-pressure product (RPP) all significantly increased 1 minute after intubation. Fentanyl was more effective
in
protecting against increase in SAP than lidocaine, which proves to be significant as shown in P<0.05. The statistical result, however, did not show the effectiveness of fentanyl significantly differed from that of esmolol in the respect. Esmolol
preloading was significantly more effective in blunting heart rate than any other drugs. On the other hand, preloading of esmolol or fentanyl was significantly more effective in blunting rate-pressure than lidocaine, which turned out to be
P<0.05.
Given these results, the present study concludes that esmolol preloading provides a reliable protection against increases in both heart rate and systolic arterial pressure accompanying laryngoscopy and intubation in hypertensive patients.
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KEYWORD
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