Partial attenuation of the cardiovascular responses to tracheal intubation with oral nisoldipine.
OBJECTIVE
To evaluate the efficacy and safety of nisoldipine given orally in attenuating the cardiovascular responses to laryngoscopy and tracheal intubation.


METHODS
Randomized, double-blind, placebo-controlled study.


METHODS
Induction of anesthesia for elective surgery at a university hospital.


METHODS
Thirty normotensive patients (ASA physical status I) undergoing elective surgery were assigned to one of three groups; placebo, nisoldipine 5 mg, or nisoldipine 10 mg. Each group consisted of ten patients.


METHODS
Either 5 mg of nisoldipine, 10 mg of nisoldipine, or a placebo was administered orally 2 hours before induction of anesthesia. Anesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Laryngoscopy lasting 30 seconds was attempted 2 minutes after administration of thiopental sodium and vecuronium.


RESULTS
Patients receiving the placebo showed a significant increase in mean arterial pressure associated with tracheal intubation. These increases following tracheal intubation were significantly reduced in patients receiving nisoldipine 10 mg compared with patients receiving the placebo (p less than 0.05).


CONCLUSIONS
Oral administration of nisoldipine before induction of anesthesia is a simple, practical, and safe method for attenuating pressor response to laryngoscopy and tracheal intubation.
Department of Anesthesiology, Kobe University School of Medicine, Japan.
N
N
Maekawa
K
K
Mikawa
M
M
Hasegawa
H
H
Kaetsu
R
R
Goto
H
H
Yaku
Y
Y
Takao
K
K
Nishina
H
H
Obara
D000284:Administration, Oral; D000328:Adult; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007828:Laryngoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015737:Nisoldipine / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D013874:Thiopental; D013997:Time Factors; D014673:Vecuronium Bromide
D010919:Placebos; D015737:Nisoldipine; D014673:Vecuronium Bromide; D013874:Thiopental