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KMID : 0376119940210020295
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Medical Journal of the Red Cross Hospital
1994 Volume.21 No. 2 p.295 ~ p.302
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The Effect of Labetalol on the Hemodynamic Response to Endotracheal Intubation
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Abstract
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Transient increases in blood pressure and heart rate following laryngoscopy and endotracheal intubation are common. These stress responses are greatly exaggerated in patients with hyperatension and cardiovascular diseases and can lead to cardiac
arrhythmia, pulmonary edema, and cerebral hemorrhage.
Many approaches have been tried to attenuate these potentially adverse circulatory responses but none has been satisfactory.
This study was made to evaluated the hemodynamic responses to tracheal intubation using combined α-and β-adrenoreceptor blocking agent, labetalol.
We intravenously administered labetalol or placebo prior to laryngoscopy and tracheal intubation in adult patients wits ASA class l or 2. Sixty patients were randomly assigned to one of three treatment group. Group l patients (control group,
n=20)received normal saline 3 ml, Group 2 patients(n=20) received labetalol 0.3mg/kg, and Group 3 patients(n=20) received labetalol 0.6mg/kg intravenously.
These drugs were injected 3 minutes before induction with thiopental sodium (5mg/kg). Succinylcholine chloride 1.0mg/kg i. v. was used to facilitate endo-tracheal intubation. After the completion of intubation, nitrous oxide/oxygen with enflurane
or
isoflurane was administered.
The blood pressure and heart rate were measured upon arrival in the operationg room (baseline), immediately before intubation, immediately after intubation, l minutes after intubation and at 2, 3, 5, 7, 10 minutes after intubation.
There were no significant differences in preinduction values of blood pre ssure and heart rate.
A significant reduction in heart rate was observed in the group 3, group 2 in that order compard with the group 1. Similarly, systolic, diastolic, mean arterial pressure decreased in labetalol groups, but was not significantly different in all
groups.
none of the patient experienced any untoward side effects, such as hypotension, significant bradycardia, bronchospasm or electrocardiographic changes.
In conclusion, in patients with no history of hypertension or significant cardiac disease, labetalol 0.3 or 0.6 mg/kg i. v. is better suited to blunting tachycardia than to blunting hypertension to laryngoscopy and intubation.
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