Effect of Diltiazem and Lidocaine on Cardiovascular Response to Tracheal Intubation / 대한마취과학회지

BACKGROUND: Transient cardiovascular responses are frequently associated with direct laryngoscopy and tracheal intubation. The aim of this study was to investigate the change of hemodynamic response in laryngoscopy and intubation after injection of diltiazem and lidocaine. METHODS: We studied eighty adult patients (ASA 1-3). After intravenous injection of thiopental sodium, each patient received saline (Control), 1 mg/kg lidocaine (Group L), 0.3 mg/kg diltiazem (Group D), or 0.3 mg/kg diltiazem + 1 mg/kg lidocaine (Group DL) 90 seconds before a laryngoscopy. Heart rate and arterial blood pressure were obtained at baseline, just before the laryngoscopy, immediately after intubation, 1, 2, 3 and 4 minutes after intubation. RESULTS: There were no significant differences in the changes of heart rate among all groups. Patients who received saline and lidocaine showed a significant increase in mean arterial pressure associated with tracheal intubation, and these responses were attenuated in diltiazem and diltiazem + lidocaine treated patients. However, there was no significant difference between the diltiazem group and diltiazem + lidocaine group. CONCLUSIONS: This data suggests that 0.3 mg/kg diltiazem or 0.3 mg/kg diltiazem + 1 mg/kg lidocaine treatment are effective methods to attenuate the hypertensive response to laryngoscopy and tracheal intubation. However, injection of diltiazem + a low dose of lidocaine was not more effective than the diltiazem alone group.

The Potentiation of the Analgesic Effect of Intrathecally Coadministered Magnesium Sulphate and Bupivacaine in Duration of Sensory Blockade in Rats / 대한마취과학회지

BACKGROUND: Based on previously reported articles, magnesium sulphate seemed to cause a motor paralysis, but not complete analgesia when administered intrathecally alone, but is likely to have a partial analgesic effect. Accordingly, we tested a hypothesis that magnesium sulphate might potentiate the analgesic effect when coadministered intrathecally with bupivacaine. METHODS: Eighteen male Sprague-Dawley rats were allocated into three groups of six animals each. The duration of sensory blockade was determined by observing the period when the animal did not vocalize and/or withdraw (struggle) while forceps-pinch tests were applied to a hindlimb paw. The six animals in each of the following three groups were injected intrathecally with 0.03 ml of the different test substances: (group 1) 16.7% magnesium sulphate {50% magnesium sulphate (0.01 ml) + 0.9% sodium chloride (0.02 ml)}; (group 2) 50% magnesium sulphate (0.01 ml) + 0.5% bupivacaine (0.02 ml); (group 3) 0.33% bupivacaine {0.5% bupivacaine (0.02 ml) + 0.9% sodium chloride (0.01 ml)}. RESULTS: Sensory blockade in the hindlimbs was observed only in group 2 and lasted for 12 to 14 minutes, while there were no sensory blockades in group 1 and group 3. CONCLUSIONS: Magnesium sulphate potentiated the analgesic effect of bupivacaine when coadministered intrathecally with bupivacaine in rats. These results suggest that intrathecal administration of magnesium sulphate may be a useful adjunct to spinal bupivacaine anesthesia.

Hemodynamic Effect of Pulmonary Artery Ligation during Pneumonectomy / 대한구급학회지

BACKGROUND: Pulmonary artery ligation during pneumonectomy increase the pulmonary blood flow of dependent lung and may increase the pulmonary arterial pressure and pulmonary vascular resistance. The purpose of this study is to evaluate the hemodynamic effect of pulmonary artery ligation during pneumonectomy. METHODS: Nine patients who were supposed to receive pneumonectomy were studied. Hemodynamic measurements were performed following two lung ventilation (TLV), one lung ventilation (OLV), after pulmonary artery ligation and after pneumonectomy. RESULTS: There is no significant differences in heart rate, systemic arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index and pulmonary vascular resistance index. Arterial oxygen tension significantly reduced during OLV and increased after pulmonary artery ligation and after pneumonectomy. CONCLUSIONS: These results suggest that pulmonary artery ligation during pneumonectomy may not affect the cardiopulmonary hemodynamics.