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KMID : 0377219990240020040
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Medical Journal of Chosun Univercity
1999 Volume.24 No. 2 p.40 ~ p.47
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Changes of Cardiovascular Responses and Plasma Catecholamines Induced by combination of Fentanyl-Midazolam During Emergency Endotracheal Intubation
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Lee Kyoung-Own
Cho Nam-Soo
Chung Ki-Ho
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Abstract
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Background and Objectives: Endotracheal intubation is accompanied with various sympathetic stimulatory responses such as increased blood pressure and heart rate. Several clinical trials to reduce the increased cardiovascular responses by pharmacologic agents including vasodilators, calcium channel blockers, lidocaine, benzodiazepines, narcotics and adrenergic blockers, have been reported. The present study attempted to investigate the changes of blood pressure, heart rate and plasma concentration of catecholamines (norepinephrine and epinephrine) before and after endotracheal intubation.
Materials and Methods: Sixty patients were selected randomly. They were divided into two groups as followings: Group I: Treated with diazepam (0.3mg/kg) (n=30) Group II: Treated with fentanyl (2.0μg/kg) and midazolam (0.02mg/kg) (n=30) The changes of systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP), heart pressure(HR) and the plasma concentration of norepinephrine and epinephrine were measured before and 1, 3, and 5 min after intubation, respectively.
Results: In group II, SBP, DBP, MAP and the plasma concentration of norepinephrine and epinephrine were significantly decreased (p＜0.05) as compared with those in group I. The heart rate also greatly decreased as compared with that of the diazepam-treated group (p＜0.05). Adverse effects by the combination of fentanyl and midazolam were not observed. treated group (p＜0.05). Adverse effects by the combination of fentanyl and midazolam were not observed.
Conclusions: Taken together, these results suggest that the coadministration of fentanyl and midazolam during emergency endotracheal intubation may attenuate postintubation-induced cardiovascular responses.
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KEYWORD
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Fentanyl, Midazolam, Norepinephrine, Epinephrine
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