Korean J Anesthesiol.  2002 Oct;43(4):436-442. 10.4097/kjae.2002.43.4.436.

The Effects of Nicardipine on Hemodynamic Responses to Tracheal Intubation in Diabetics with Autonomic Neuropathy

• Choe MH
• Kim DC
• Han YJ
• Choe H

• KMID: 2033616
• DOI: http://doi.org/10.4097/kjae.2002.43.4.436

Abstract

BACKGROUND: A laryngoscopy and tracheal intubation often provoke an undesirable increase in blood pressure and heart rate. These hemodynamic responses to tracheal intubation in diabetics are blunted due to autonomic neuropathy. This study was designed to determine the optimal dose of nicardipine in diabetic autonomic neuropathy patients.
METHODS
According to the nicardipine dose, 80 diabetics were randomly allocated to four groups of 20 patients. Tracheal intubation by direct laryngoscopy was performed. After intravenous thiopental 5 mg/kg, vecuronium 0.13 mg/kg and one of the dosages of nicardipine 3, 5, or 7microgram/kg followed by mask ventilation of three minutes with enflurane, nitrous oxide and oxygen. Heart rate and blood pressure were mesured five times at one minute intervals.
RESULTS
There was no significant difference in the 3microgram/kg group compared with the control group. On the other hand, there was a sufficient blood pressure decrease in the 5microgram/kg and 7microgram/kg group. However, in the 7microgram/kg group, 55% of cases showed severe hypotension (< 70 mmHg).
CONCLUSIONS
We suggest that the appropriate dose of nicardipine for prevention of tachycardia, and hypertension in diabetic autonomic neuropathy patients is 5microgram/kg.

Keyword

Diabetic autonomic neuropathy; intubation; nicardipine

MeSH Terms

Blood Pressure
Diabetic Neuropathies
Enflurane
Hand
Heart Rate
Hemodynamics*
Humans
Hypertension
Hypotension
Intubation*
Laryngoscopy
Masks
Nicardipine*
Nitrous Oxide
Oxygen
Tachycardia
Thiopental
Vecuronium Bromide
Ventilation
Enflurane
Nicardipine
Nitrous Oxide
Oxygen
Thiopental
Vecuronium Bromide