Korean J Anesthesiol.  1995 Jan;28(1):55-64. 10.4097/kjae.1995.28.1.55.

The Cardiovascular Effects of Rapid Sequence Induction and Slow Induction in Normotensive Patients

• Ko SH
• So SY
• Kim DC
• Han YJ
• Song HS

• KMID: 2090886
• DOI: http://doi.org/10.4097/kjae.1995.28.1.55

Abstract

The circulatory stimulation accompanying laryngoscopy and tracheal intubation and its attendant potential hazards are well recognized. This study was perfomed to compare cardiovascular effects of rapid sequence induction with slow induction during induction of anesthesia and following tracheal intubation with laryngoscope. Eighty six adult patients ASA class I or II, ages 20-55, with no previous history of hypertension and pulmonary diseases that undergoing elective surgery requiring intubation, were admitted to the study. These patients were randomly divided into four groups. Group 1. Rapid sequence induction (n=20) Group 2. Slow induction for 7min. (n=20) Group 3. Slow induction for 10min. (n=21) Group 4. Slow induction for 15min. (n=25) Anesthesia was induced with lidocaine 1.5mg/kg and thiopental sodium 5mg/kg i.v. in a rapid sequence induction in group 1. Tracheal intubation with laryngoscope was facilitated with succinylcholine chloride 1mg/kg iv. Thereafter 50% nitrous oxide in oxygen, 2.0 vol% enflurane, and vecuronium bromide 0.1mg/kg was administered. Group 2, 3, 4 patients received thiopental sodium 5mg/kg iv, vecuronium bromide 0.1mg/kg iv, 2.0 vol% enflurane and 5096 nitrous oxide in oxygen with mask ventilation for 7 min, 10 min and 15 min before intubation with laryngoscope, respectively. After tracheal intubation inhalation of the anesthetic gases were administered. Blood pressure and heart rate measurements and electrocardiography were obtained throughout the study period. Slow induction (Group 2, 3, 4) significantly blunted the increase in heart rate and blood pressure caused by laryngoscopy and endotracheal intubation than rapid sequence induction (group 1). Less unwanted effects were observed in group 2 and 3. Therefore, the author suggests that 7-10 minute of slow induction with volatile anesthetics following thiopental sodium injection is more effective in attenuating cardiovascular responses to tracheal intubation and laryngoscopy.

Keyword

Laryngoscopy; Tracheal intubation; Cardiovascular effect; Rapid sequence induction slow induction

MeSH Terms

Adult
Anesthesia
Anesthetics
Anesthetics, Inhalation
Blood Pressure
Electrocardiography
Enflurane
Heart Rate
Humans
Hypertension
Inhalation
Intubation
Intubation, Intratracheal
Laryngoscopes
Laryngoscopy
Lidocaine
Lung Diseases
Masks
Nitrous Oxide
Oxygen
Succinylcholine
Thiopental
Vecuronium Bromide
Ventilation
Anesthetics
Anesthetics, Inhalation
Enflurane
Lidocaine
Nitrous Oxide
Oxygen
Succinylcholine
Thiopental
Vecuronium Bromide