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Canadian Journal of Anesthesia, Vol 45, 933-937, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Diltiazem-lidocaine combination for the attenuation of cardiovascular responses to tracheal intubation in hypertensive patients

Y Fujii, Y Saitoh, S Takahashi and H Toyooka
Department of Anaesthesiology, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.

PURPOSE: Hypertensive patients are prone to haemodynamic changes after laryngoscopy and tracheal intubation. This study was undertaken to compare the efficacy of a combination of diltiazem and lidocaine with that of each drug alone for suppressing the cardiovascular responses to tracheal intubation. METHODS: Sixty hypertensive patients (ASA II), defined as systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 95 mmHg (World Health Organization), undergoing elective surgery received, in a randomized, double-blind manner, 0.3 mg.kg-1 diltiazem, 1.5 mg.kg-1 lidocaine, or 0.3 mg.kg-1 diltiazem plus 1.5 mg.kg-1 lidocaine i.v. (n = 20 of each) before the initiation of laryngoscopy. Anaesthesia was induced with 5 mg.kg-1 thiopentone i.v., and tracheal intubation was facilitated with 2 mg.kg-1 succinylcholine i.v. after precurarization with 0.02 mg.kg-1 vecuronium i.v. Changes in heart rate (HR), mean arterial pressure (MAP) and rate-pressure product (RPP) were measured before and at immediate, 1, 2, 3, 5 and 10 min after tracheal intubation. RESULTS: The inhibitory effects of diltiazem-lidocaine combination on cardiovascular responses to tracheal intubation was greater than those of diltiazem or lidocaine as a sole medicine (RPP; 10,602 +/- 1448 (combination) vs 11,787 +/- 1345 (diltiazem), 15,428 +/- 1756 (lidocaine), mean +/- SD, P < 0.05). CONCLUSION: Prophylactic therapy with diltiazem-lidocaine combination is more effective than diltiazem or lidocaine alone for attenuating the cardiovascular changes associated with tracheal intubation in hypertensive patients.


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 Canadian J. AnesthesiaHome page
K. Takita, Y. Morimoto, and O. Kemmotsu
Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation : [L'administration tracheale de lidocaine diminue la reponse cardio-vasculaire a l'intubation endotracheale]
Can J Anesth, September 1, 2001; 48(8): 732 - 736.
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Copyright © 1998 by the Canadian Anesthesiologists' Society.