Effects of Alfentanil on Hemodynamic and Catecholamine Responses to Laryngoscopy and Endobronchial Intubation in the Elderly / 대한구급학회지
The Korean Journal of Critical Care Medicine
;
: 114-120, 2005.
Article
in English
| WPRIM
| ID: wpr-652814
ABSTRACT
BACKGROUND:
Endobronchial intubation should elicit significant circulatory responses. We examined the effects of alfentanil on hemodynamic and catecholamine responses to endobronchial intubation in elderly patients.METHODS:
A total of 60 patients aged over 60 years requiring endobronchial intubation were randomized into three groups of 20 patients each. Anesthesia was induced with thiopental 4~6 mg/kg followed by saline (placebo) or alfentanil 10 or 30microgram/kg given as a bolus over 30 s. Succinylcholine 1 mg/kg was given for neuromuscular block. Laryngoscopy and intubation were performed 1 min later.RESULTS:
The intubation significantly increased systolic arterial pressure and heart rate. The maximum pressure changes from pre-intubation values in both alfentanil groups (58+/-27 and 33+/-30 mm Hg in 10 and 30microgram/kg, respectively) were significantly lower compared with that of 83+/-35 mm Hg in the control group. The tachycardiac response was not significantly affected by alfentanil 10microgram/kg, but attenuated by alfentanil 30microgram/kg. The plasma norepinephrine concentrations were increased, which was not affected by alfentanil 10microgram/kg, but was significantly attenuated by alfentanil 30microgram/kg. Both doses of alfentanil abolished the increase of plasma epinephrine concentrations. Three patients in the 30microgram/kg group received ephedrine for hypotension.CONCLUSIONS:
This study showed that endobronchial intubation elicited significant pressor response, and that alfentanil 30microgram/kg is more efficacious in attenuating the hemodynamic and catecholamine responses, although potential hypotension warrants a caution of its use, in elderly patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Plasma
/
Succinylcholine
/
Tachycardia
/
Thiopental
/
Catecholamines
/
Epinephrine
/
Norepinephrine
/
Alfentanil
/
Neuromuscular Blockade
/
Ephedrine
Type of study:
Controlled clinical trial
Limits:
Aged
/
Humans
Language:
English
Journal:
The Korean Journal of Critical Care Medicine
Year:
2005
Type:
Article
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