J Korean Soc Emerg Med.  1997 Sep;8(3):398-406.

Effect of Diazepam on the Catecholamine Response to Endotracheal Intubation in Multiple Trauma Patients

• Cho NS
• Kim YB
• Choi BN

Abstract

BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed.
METHODS
The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05.
RESULTS
1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I.
CONCLUSION
It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.

MeSH Terms

Adrenocorticotropic Hormone
Benzodiazepines
Blood Pressure
Cardiovascular System
Diazepam*
Emergency Service, Hospital
Epinephrine
Femoral Artery
Heart Rate
Humans
Hydrocortisone
Intubation
Intubation, Intratracheal*
Laryngoscopy
Multiple Trauma*
Muscle, Skeletal
Norepinephrine
Prolactin
Relaxation
Young Adult
Adrenocorticotropic Hormone
Benzodiazepines
Diazepam
Epinephrine
Hydrocortisone
Norepinephrine
Prolactin