The Effects of a Combination of Nicardipine and Esmolol on Blood Pressure and Heart Rate after Endotracheal Intubation in Hypertensive Patients / 대한마취과학회지

ABSTRACT

BACKGROUND: This study was designed to determine the efficacy of a combined use of esmolol and nicardipine for blunting hypertension and tachycardia after tracheal intubation in hypertensive patients. METHODS: Forty-five hypertensive patients were randomly divided into three group group E (esmolol 0.5 mg/kg, n = 15), group N (nicardipine 30microgram/kg, n = 15), group EN (esmolol 0.25 mg/kg, nicardipine 15microgram/kg, n = 15). All patients received midazolam 0.5 mg/kg, and glycopyrrolate 0.2 mg IM for premedication. Fentanyl 1microgram/kg was injected before induction of anesthesia, and then esmolol, nicardipine, or the mixed drugs were administrated as an IV bolus and immediately followed by the induction drugs thiopental 5 mg/kg, and succinylcholine 1 mg/kg. Endotracheal intubation was performed 90 seconds after injection of the experimental drugs. Thereafter 50% Nitrous Oxide in oxygen and 2 vol % enflurane were inhaled. BP and HR were recorded at the resting state, before fentanyl injection (base {T0}), after injection test drug (T1), after induction (T2), immediately after intubation (T3), 2 min (T4), 3 min (T5), 4 min (T6), and 5 min (T7) after intubation. RESULTS: There was a significant attenuation in SBP, MBP, DBP after tracheal intubation on the nicardipine and mixed groups compared to the esmolol group. HR was significantly lower in the esmolol and mixed groups than in the nicardipine group after tracheal intubation. CONCLUSIONS: Combined administration of esmolol (0.25 mg/kg) and nicardipine (15microgram/kg) was effective in attenuating an increase of BP and HR during tracheal intubation in hypertensive patients.