Korean J Anesthesiol.  1996 Jun;30(6):668-675. 10.4097/kjae.1996.30.6.668.

Effect of Sublinguial Nefedipine on Blood Pressure, Heart Rate and Muscular Relaxation During Tracheal Intubation

• Choi YJ
• Kim CH
• Lee CH

• KMID: 1934796
• DOI: http://doi.org/10.4097/kjae.1996.30.6.668

Abstract

BACKGROUND: Direct laryngoscopy & tracheal intubation for general anesthesia often provoke a marked sympathetic response. Such sympathetic response may be inconsequential in healthy patients but detrimental to those with ischemic heart disease or increased intracranial pressure.
METHODS
Cardiovascular parameters after sublinguial administration of nifedipine(nifedipine group, n=13) were compared with parameters which derived from not administred nifedipine(control group, n=15), before administration of nifedipine, 5 minutes after adminitration, immediately before and after intubation, 2.5, 5, 7.5, 10 minutes following intubation. And the muscle twitch, clinical degree of muscular relaxation of intubation condition, the arterial blood gas analysis & electrolyte were measured.
RESULTS
1) The times to 75% and 100% twitch depression of vecuronium and clinical degree of muscle relaxation of intubation condition were no differences in both groups. 2) In both group, heart rate increased immediatly after intubation and thereafter decreased. But it was higher than basal value until 10 minutes after intubation in nifedipine group. 3) Systolic and diastolic arterial pressure increased significantly in both groups and these were decreased significantly in nifedipine group. 4) At arterial blood gas analysis, pH increased significantly and PaCO2 decreased at 15 minutes after nifedipine administration in both groups, compared to basal value. 5) There were no significant differences in electrolyte (Na+, K+, Ca++) values between two groups.
CONCLUSIONS
In healthy adult patients, rise in the arterial blood pressure after tracheal mtubation decreased effectively with subligual nifedipine but nifedipine may produce excessive myocardial depression in patient with preexisting left ventricular dysfunction.

Keyword

Anesthetics techniques; Intubation; Blood pressure; Heart; nifedipine; pulse rate; Monitoring; blood gas; arterial

MeSH Terms

Adult
Anesthesia, General
Arterial Pressure
Blood Gas Analysis
Blood Pressure*
Depression
Heart Rate*
Heart*
Humans
Hydrogen-Ion Concentration
Intracranial Pressure
Intubation*
Laryngoscopy
Muscle Relaxation
Myocardial Ischemia
Nifedipine
Relaxation*
Vecuronium Bromide
Ventricular Dysfunction, Left
Nifedipine
Vecuronium Bromide