Korean J Anesthesiol.  2005 Aug;49(2):136-141. 10.4097/kjae.2005.49.2.136.

The Effects of Alfentanil and a Combination of Alfentanil and Esmolol on Hemodynamic Responses after Endotracheal Intubation in Hypertensive Patients

• Kang H
• Lee IG
• Cho CK
• Baek CH
• Park JW
• Jung YH
• Woo YC
• Kim JY
• Koo GH
• Park SG

• KMID: 2092019
• DOI: http://doi.org/10.4097/kjae.2005.49.2.136

Abstract

BACKGROUND: This study was desined to determine the efficacy and clincial usefulness of alfentanil and a combined use of alfentanil and esmolol for blunting hemodynamic responses after tracheal intubation in hypertensive patients who needed a rapid sequence induction.
METHODS
Group 1 received alfentanil 15microgram/kg and group 2 received alfentanil 15microgram/kg and esmolol 1 mg/kg intravenously. Thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg were used for the induction of anesthesia. Changes in blood pressure and herat rate were measured during intubation and induction of anesthesia with enflurane-N2O-O2 and vecuronium. Rate pressure products (RPP) was calculated and the frequencies of hypertension, hypotension, tachycardia, bradycardia were measured.
RESULTS
In group 1, systolic blood pressure increased significantly at 1, 2 minute and decreased significantly at 4, 5, 10, 15 minute compared to base, and diastolic blood pressure increased significantly at 1 minute and decreased significantly at 4, 5, 10 minute. Heart rate increased significantly at 1, 2 minute. In group 2, systolic blood pressure decrease significantly at 3, 4, 5 minute after tracheal intubation compared to base, and diastolic blood pressure increased at 1 minute and decreased at 4, 5, 10, 15 minute. HR did not change significantly (P < 0.05).
CONCLUSION
In treated hypertensive patients, the use of a combination of alfentanil 15/kg and esmolol 1 mg/kg is a useful method to attenuate hemodynamic responses after endotracheal intubation and especially for rapid sequence induction.

Keyword

alfentanil; esmolol; hypertension; intubation

MeSH Terms

Alfentanil*
Anesthesia
Blood Pressure
Bradycardia
Heart Rate
Hemodynamics*
Humans
Hypertension
Hypotension
Intubation
Intubation, Intratracheal*
Succinylcholine
Tachycardia
Thiopental
Vecuronium Bromide
Alfentanil
Succinylcholine
Thiopental
Vecuronium Bromide