Effects of prostaglandin E1 on the cardiovascular response to tracheal intubation.
OBJECTIVE
To evaluate the efficacy of prostaglandin E1 in attenuating the hypertensive response to laryngoscopy and intubation.


METHODS
Controlled, comparative, and randomized study.


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


METHODS
Thirty normotensive patients (ASA physical status I) undergoing elective surgery divided into three groups. Each group consisted of ten patients.


METHODS
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.


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.
Mikawa
K
K
Department of Anesthesiology, Kobe University School of Medicine, Japan.
Ikegaki
J
J
Maekawa
N
N
Hoshina
H
H
Tanaka
O
O
Goto
R
R
Obara
H
H
D000527:Alprostadil / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D000527:Alprostadil