Mikawa K, Ikegaki J, Maekawa N, Hoshina H, Tanaka O, Goto R, Obara H. Effects of prostaglandin E1 on the cardiovascular response to tracheal intubation.
J Clin Anesth 1990;
2:420-4. [PMID:
2271205 DOI:
10.1016/0952-8180(90)90029-3]
[Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
STUDY OBJECTIVE
To evaluate the efficacy of prostaglandin E1 in attenuating the hypertensive response to laryngoscopy and intubation.
DESIGN
Controlled, comparative, and randomized study.
SETTING
Induction of anesthesia for elective surgery at a university hospital.
PATIENTS
Thirty normotensive patients (ASA physical status I) undergoing elective surgery divided into three groups. Each group consisted of ten patients.
INTERVENTIONS
Anesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. Either 0.3 micrograms/kg of prostaglandin E1, 0.6 micrograms/kg of prostaglandin E1, or saline (control) was injected 15 seconds before starting direct laryngoscopy (within 30 seconds), which was attempted 2 minutes after administration of thiopental sodium and vecuronium.
MEASUREMENTS AND MAIN RESULTS
Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increases following tracheal intubation were significantly less in prostaglandin E1-treated patients than in the control group (p less than 0.05).
CONCLUSIONS
A single rapid intravenous administration of prostaglandin E1 is a practical pharmacologic and safe method to attenuate the hypertensive response to tracheal intubation. The use of 0.6 micrograms/kg of prostaglandin E1 as a supplement during induction is recommended for reducing the pressor response to intubation on the basis of rate-pressure product and mean arterial pressure following intubation as an index.
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