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

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.

Extreme Hypotension Followed by an Intravenous Indigo Carmine Injection during a Radical Prostatectomy: A case report / 대한마취과학회지

Indigo carmine (sodium indigotin disulfonate) is a blue dye that is generally regarded as a safe and inactive material. It is widely used in urology and gynecology to identify the ureteral orifice. Occasionally it causes high blood pressure, bradycardia, nausea and vomiting as side effects. Though rare, it can cause a skin rash, pruritus, and bronchospasm as well. However, it is known that hypotension is extremely uncommon. We report an experience of extreme hypotension that happened immediately after an intravenous indigo carmine injection during a radical prostatectomy under general anesthesia.