BACKGROUND: Laryngoscopy and endotracheal intubation for general anesthesia cause tachycardia and hypertension due to sympathetic stimulation. The purpose of this study is comparison of effects of lidocaine, fentanyl, and esmolol on blood pressure and heart rate changes owing to tracheal intubation during propofol induction. METHODS: Pateints were randomly received one of the following study drug intravenously prior to induction : Group 1(normal saline 5 ml, n=20) ; Group 2 (lidocaine 1.5 mg/kg, n=20) ; Group 3 (fentanyl 2 microgram/kg, n=20) ; Group 4 (esmolol 1.0 mg/kg, n=20). Anesthesia was induced with propofol 2.5 mg/kg IV and then maintained with 50% nitrous oxide in oxygen and 1.0 vol% isoflurane. Systolic and diastolic blood pressure and heart rate were measured preinduction, after induction, immediately after intubation, and 1, 3, 5, 7, 9, 11 minutes following intubation. RESULTS: After intubation, the increase in systolic blood pressure and heart rate were blunted significantly compared with the control group in the group 3 (p<0.05). In the group 4, the increase in blood pressure was not suppressed but modified and tachycardia was not prevented after intubation. CONCLUSIONS: Fentanyl 2 microgram/kg was suppressed blood pressure changes and effective in attenuating tachycardia during propofol induction compare with control and lidocaine groups. Esmolol 1.0mg/kg was effective in attenuating blood pressure changes owing to tracheal intubation.
Anesthesia ; Anesthesia, General ; Blood Pressure* ; Fentanyl* ; Heart Rate* ; Heart* ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngoscopy ; Lidocaine* ; Nitrous Oxide ; Oxygen ; Propofol* ; Tachycardia

Benign prostsatic hypertrophy is a common disease of middle-aged and elderly men that nacessitates surgical resection of ths prostatic gland, and tranaurethral resetion is the second most common surgical procedure in men over the age 65. This geriatric patient population generally carries greater anesthetic risk than the young because of greater prevalenee of coexisting cardiovascular or pulmonary diseases. Futhermore,because transurethral resection carries a number of complications such as bleeding requiring transfusion, TURP syndrome, arrhythmia, hemolysis, coagulopathy, sepsis, bladder perforation, and pulmonary edems, transurethral resection is of concern to anesthesiologists. Thus, we had reviewed clinical records of 40lcases of benign prostatic hypertrophy and performed clinical and statistical analysis according to sge, ASA physical status, preoperative abnormal laboratory findings, combined disesses, anesthetic techniques, resection time of prostate, volume of irrigation fluid, weight of resected prostate, transfusion, intraoperative and postoperative complications. The results were as follows. 1) Of the 401 cases, 175 cases(43.6% ) were 61-70 years of age. 2) The most common ASA physical status was class 2(73.6%). 3) Of the operative methods, most common was TURP(89.5% ). 4) Preoperative cheat X-ray evaluation showed abnormalities in 167 cases(41.6%); 52 cases(31.1% ) had hypertensive heart configuration, 40 cases(24.0% ) had inactive pulmonary tuberculosisnd 39 case(23.4%) had pleural thickening. 5) Preoperative abnormal ECG findings were found in 150 casee(37.4%); 52 cases(34.7 %) had LVH, 43 cases(28.7%) had heart block,and 35 csses(23.3%) had myocardial ische-mia. 6) Preoperative pulmonary function test showed abnormalities in 101 cases(25.2%), most common abnormal finding was small airway obstruction disease(22.8% ). 7) The sssociated diseases were 146 cases(36.4%) snd most commonly associated disease was hypertension(36.3%). 8) The number of epidural anesthesia was performed in 218 cases(54.4%); general anesthesia, in 118(29.4%) and spinal anesthesia,in 65(16.2%). The duration of resection time was less than 1 hour in 315 cases(87.8%). 9) The mean value of the volume of irrigation fluid was 15.6+/-8.2L, and the mean value of weight of resected prostate was 22.4+/-16.9g. 10) Total number of intraoperative complications were 60 cases; 6 cases were ECG abnormalities, 32 cases were bleeding, and 12 csses were intraoperative hypotension. Postoperative complications were bleeding and acute myocardial infarction, but there was no death.
Aged ; Airway Obstruction ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Arrhythmias, Cardiac ; Electrocardiography ; Heart ; Hemolysis ; Hemorrhage ; Humans ; Hypertrophy ; Hypotension ; Intraoperative Complications ; Lung Diseases ; Male ; Myocardial Infarction ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia* ; Respiratory Function Tests ; Sepsis ; Transurethral Resection of Prostate ; Urinary Bladder

Benign prostsatic hypertrophy is a common disease of middle-aged and elderly men that nacessitates surgical resection of ths prostatic gland, and tranaurethral resetion is the second most common surgical procedure in men over the age 65. This geriatric patient population generally carries greater anesthetic risk than the young because of greater prevalenee of coexisting cardiovascular or pulmonary diseases. Futhermore,because transurethral resection carries a number of complications such as bleeding requiring transfusion, TURP syndrome, arrhythmia, hemolysis, coagulopathy, sepsis, bladder perforation, and pulmonary edems, transurethral resection is of concern to anesthesiologists. Thus, we had reviewed clinical records of 40lcases of benign prostatic hypertrophy and performed clinical and statistical analysis according to sge, ASA physical status, preoperative abnormal laboratory findings, combined disesses, anesthetic techniques, resection time of prostate, volume of irrigation fluid, weight of resected prostate, transfusion, intraoperative and postoperative complications. The results were as follows. 1) Of the 401 cases, 175 cases(43.6% ) were 61-70 years of age. 2) The most common ASA physical status was class 2(73.6%). 3) Of the operative methods, most common was TURP(89.5% ). 4) Preoperative cheat X-ray evaluation showed abnormalities in 167 cases(41.6%); 52 cases(31.1% ) had hypertensive heart configuration, 40 cases(24.0% ) had inactive pulmonary tuberculosisnd 39 case(23.4%) had pleural thickening. 5) Preoperative abnormal ECG findings were found in 150 casee(37.4%); 52 cases(34.7 %) had LVH, 43 cases(28.7%) had heart block,and 35 csses(23.3%) had myocardial ische-mia. 6) Preoperative pulmonary function test showed abnormalities in 101 cases(25.2%), most common abnormal finding was small airway obstruction disease(22.8% ). 7) The sssociated diseases were 146 cases(36.4%) snd most commonly associated disease was hypertension(36.3%). 8) The number of epidural anesthesia was performed in 218 cases(54.4%); general anesthesia, in 118(29.4%) and spinal anesthesia,in 65(16.2%). The duration of resection time was less than 1 hour in 315 cases(87.8%). 9) The mean value of the volume of irrigation fluid was 15.6+/-8.2L, and the mean value of weight of resected prostate was 22.4+/-16.9g. 10) Total number of intraoperative complications were 60 cases; 6 cases were ECG abnormalities, 32 cases were bleeding, and 12 csses were intraoperative hypotension. Postoperative complications were bleeding and acute myocardial infarction, but there was no death.
Aged ; Airway Obstruction ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Arrhythmias, Cardiac ; Electrocardiography ; Heart ; Hemolysis ; Hemorrhage ; Humans ; Hypertrophy ; Hypotension ; Intraoperative Complications ; Lung Diseases ; Male ; Myocardial Infarction ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia* ; Respiratory Function Tests ; Sepsis ; Transurethral Resection of Prostate ; Urinary Bladder