Cardiovascular Responses to Endotracheal Intubation in Patients Receiving Desflurane Anesthesia for Anesthetic Induction.
10.4097/kjae.2004.46.6.652
- Author:
Cheol Won JEONG
1
;
Sang Hyun KWAK
;
Myung Ha YOON
;
Sung Su CHUNG
;
Chang Young JEONG
;
In Ho HA
;
Jong Duk CHO
;
Kyung Yeon YOO
Author Information
1. Department of Anesthesiology, College of Dentistry, Chonnam National University Medical School, Gwangju, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
endotracheal intubation;
catecholamine;
desflurane;
hypertension;
tachycardia
- MeSH:
Anesthesia*;
Arterial Pressure;
Heart Rate;
Hemodynamics;
Humans;
Hypertension;
Intubation;
Intubation, Intratracheal*;
Norepinephrine;
Oxygen;
Plasma;
Tachycardia;
Thiopental;
Vecuronium Bromide
- From:Korean Journal of Anesthesiology
2004;46(6):652-657
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Desflurane is known to augment central and systemic sympathetic nervous activity. The present study was aimed at examining the effects of desflurane on cardiovascular responses to intubation. METHODS: Seventy-five ASA physical status I patients (aged 35-60 yr) were assigned randomly to receive one of three treatment regimens (n = 25 each): 1 minimum alveolar concentration (MAC) of sevoflurane, 1 MAC of desflurane or 2 MAC of desflurane. Anesthesia was induced with IV thiopental (5 mg/kg), while patients were ventilated with 100% oxygen. Tracheal intubation was facilitated with IV vecuronium (0.12 mg/kg). After intubation, patients received each anesthetic gas in oxygen via a semiclosed anesthesia circuit. Systolic arterial blood pressure (SAP), heart rate (HR) and rhythm, and plasma catecholamine concentrations were measured. RESULTS: The intubation resulted in immediate increases of SAP and HR in all groups; peak effects occurred within 1 min of the intubation. In addition, 2 MAC desflurane elicited a secondary hemodynamic effect at 3 to 5 min after the intubation. The plasma concentrations of norepinephrine increased significantly when measured at 1 min after intubation in all groups, and returned to preintubation values at 5 min in the 1 MAC desflurane groups, but showed further increases at 5 min in the 2 MAC group. CONCLUSIONS: These results show that 2 MAC desflurane elicits a biphasic hemodynamic response along with an augmented norepinephrine release, where the first appears within 1 min and the second at 3 to 5 min after intubation.
