ABSTRACT
BACKGROUND: Laryngoscopy and tracheal intubation often provoke an undesirable increase in blood pressure and heart rate. Nicardipine-induced reduction in blood pressure was greater with inhalational anesthetics than nicardipine alone. This study was designed to determine the optimal dose of nicardipine for acceptable hemodnamic change during inhalation with sevoflurane. METHODS: Eighty ASA physical status 1 patients were randomly allocated into four groups of twenty patients. Tracheal intubation under direct laryngoscopy was performed. After intravenous thiopental 5 mg/kg, vecuronium 0.13 mg/kg 5, 10 or 15microgram/kg of nicardipine was given intravenously followed by mask ventilation of three minutes with sevoflurane, nitrous oxide and oxygen. Heart rate and blood pressure were measured at the period of baseline, preintubation, immediately after intubation, 1, 2, 4, 6 and 9 minutes following intubation. RESULTS: After tracheal intubation, the increase of systolic blood pressure was suppressed significantly by nicardipine 10 and 15microgram/kg group compared with the control group. The increase of heart rate was greatest in the nicardipine 15microgram/kg group. CONCLUSIONS: We suggest that the appropriate dose of nicardipine during induction with sevoflurane for attenuation of pressor responses to laryngoscopy and intubation in healthy patients is 10microgram/kg.
Subject(s)
Humans , Anesthetics , Blood Pressure , Heart Rate , Hemodynamics , Inhalation , Intubation , Laryngoscopy , Masks , Nicardipine , Nitrous Oxide , Oxygen , Thiopental , Vecuronium Bromide , VentilationABSTRACT
Percutaneous nephrolithotomy (PCNL) is a well-established procedure for treating nearly all types of stones in the kidneys and middle-to-upper ureters. In addition, PCNL is less invasive, and provides safe results comparable to open surgery. However, there is risk of an increased risk of thoracic complications when performing a puncture above the 12 th rib to optimize kidney access. We experienced a 30-years-old female who had oxygen desaturation and complained dyspnea and chest pain at the postanesthetic care unit after percutaneous nephrolithotomy. Therefore, patients undergoing percutaneous renal manipulation need to be monitored for pulmonary complications during and after the procedure.