Korean J Anesthesiol.  2002 Dec;43(6):710-715. 10.4097/kjae.2002.43.6.710.

Effect of Diltiazem and Lidocaine on Cardiovascular Response to Tracheal Intubation

• Lee KH
• Jun ES
• Chae YJ
• Park GS
• Choi JC
• Lim HK

• KMID: 1860631
• DOI: http://doi.org/10.4097/kjae.2002.43.6.710

Abstract

BACKGROUND: Transient cardiovascular responses are frequently associated with direct laryngoscopy and tracheal intubation. The aim of this study was to investigate the change of hemodynamic response in laryngoscopy and intubation after injection of diltiazem and lidocaine.
METHODS
We studied eighty adult patients (ASA 1-3). After intravenous injection of thiopental sodium, each patient received saline (Control), 1 mg/kg lidocaine (Group L), 0.3 mg/kg diltiazem (Group D), or 0.3 mg/kg diltiazem + 1 mg/kg lidocaine (Group DL) 90 seconds before a laryngoscopy. Heart rate and arterial blood pressure were obtained at baseline, just before the laryngoscopy, immediately after intubation, 1, 2, 3 and 4 minutes after intubation.
RESULTS
There were no significant differences in the changes of heart rate among all groups. Patients who received saline and lidocaine showed a significant increase in mean arterial pressure associated with tracheal intubation, and these responses were attenuated in diltiazem and diltiazem + lidocaine treated patients. However, there was no significant difference between the diltiazem group and diltiazem + lidocaine group.
CONCLUSIONS
This data suggests that 0.3 mg/kg diltiazem or 0.3 mg/kg diltiazem + 1 mg/kg lidocaine treatment are effective methods to attenuate the hypertensive response to laryngoscopy and tracheal intubation. However, injection of diltiazem + a low dose of lidocaine was not more effective than the diltiazem alone group.

Keyword

Intubation; diltiazem; lidocaine

MeSH Terms

Adult
Arterial Pressure
Diltiazem*
Heart Rate
Hemodynamics
Humans
Injections, Intravenous
Intubation*
Laryngoscopy
Lidocaine*
Thiopental
Diltiazem
Lidocaine
Thiopental