The Effects of Remifentanil, Lidocaine, Nicardipine and Nitroglycerin on Hemodynamic Changes during Tracheal Intubation / 대한마취과학회지

BACKGROUND: This study was conducted to compare the effects of remifentanil, lidocaine, nicardipine and nitroglycerin used in conjunction with thiopental-sevoflurane on hemodynamic changes induced by direct laryngoscopy and tracheal intubation. METHODS: Seventy-five ASA class I or II patients scheduled for elective surgery were randomly divided into 5 groups. After induction of anesthesia with thiopental, sevoflurane and rocuronium, they were administered an intravenous bolus of either saline (Group S), remifentanil 1microgram/kg (Group R), lidocaine 1.5 mg/kg (Group L), nicardipine 20microgram/kg (Group N) or nitroglycerin 2microgram/kg (Group G). Tracheal intubation was then conducted 90 seconds after the drug was administered. The systolic blood pressure, diastolic blood pressure and heart rate were measured prior to the administration of anesthesia, before intubation, at 1 min after intubation and at 3 min after intubation for each patient. RESULTS: The systolic blood pressure, diastolic blood pressure and heart rate at 1 min after intubation were significantly lower in Group R than in Group S. In addition, the systolic blood pressure and diastolic blood pressure prior to intubation were significantly lower in Group N than in Group S. CONCLUSIONS: Remifentanil 1microgram/kg was most effective at controlling hemodynamic changes induced by direct laryngoscopy and tracheal intubation when compared with lidocaine, nicardipine and nitroglycerin.

The general anesthesia experience of cornelia de lange syndrome patient: A case report / 대한마취과학회지

Cornelia de Lange syndrome (Amsterdam dwarfism) is a congenital disease characterized by mental retardation associated with multiple malformation.A genetic etiology has been proposed, with suggestions of autosomal dominant and recessive inheritance. It affects one in 30,000 to 60,000 live births.Two-thirds of patients with the condition die before the end of their first year; death occurs from pulmonary aspiration in infancy, and from infections and bowel obstruction in later life.One reference to the syndrome highlights problems with seizures, cardiac abnormalities and difficult tracheal intubation but apart from this paper, there is little published information about the anesthetic management.