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KMID : 0377819910110111393
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Diagnosis and Treatment
1991 Volume.11 No. 11 p.1393 ~ p.1400
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EFFECTS OF TRIMETHAPHAN ON BLOOD PRESSURE AND HEART RATE DURING LARYNGOSCOPY AND TRACHEAL INTUBATION
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Abstract
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Because of attenuation of blood pressure by trimethaphan, we measured hemodynamic response especially blood pressure, heart rate and rate pressure product in 90 consecutive patients. Group Ⅰ patients (n=30) receiveda single saline solution(3ml). Group Ⅱ patients (n=30) received a single intravenous injection of trimethaphan, 0.05 mg kg^(-1) at 1.75 min before start of laryngoscopy. Group Ⅲ patients (n=30) received a single intravenous injection of injection of trimethaphan, 0.1mg kg^(-1) at 1.75 min before start of laryngoscopy. Anesthesia was induced with thiopentone 5mg kg^(-1) i.v. and tracheal intubation was facilitated with Vecuronium, 0.2mg kg^(-1)
During anesthesia, ventilation was assisted or controlled with 1.5-2.0 vol % enflurane and 50% nitrous oxide in oxygen; Blood -pressure, heart rate and rate pressure product were measured before induction, 30 seconds after trimethaphan injection, 1.5 minutes after trimethaphan injection, and I minute, 3 minutes, 5 minutes after intubation.
The results obtained were as follows ;
1. The systolic blood pressure in Group H and Group X was decreased significantly compared to that of Group I (P＜0.01) 1. 5 minutes after a single injection of trimethaphan.
2. Heart rate in Group M was significantly de-creased 1.5 minutes after trimethaphan injection (P＜0.01), 3 minutes after intubation (P＜0.05), and 5 minutes after intubation (P＜0.01) compared to Group Ⅰ.
3. Rate Pressure product was increased in the three groups compared to preinduction level, but was significantly decreased at 1.5 minutes after trimethaphan injection in Group Ⅱ (P＜0.05) and Group Ⅲ (P＜0.01), and 5 minutes after intubation in Group Ⅱ (P＜0.05) and Group Ⅲ (P＜0.01) compared to Group Ⅰ.
These data suggest that trimethaphan may be used as a supplement during induction, to attenuate the hypertensive response associated with laryngoscopy and tracheal incubation.
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