title: Effect of labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study.
abstract: Labetalol, a combined alpha 1- and nonselective beta-adrenergic blocking drug, was compared to lidocaine or saline to minimize the hypertensive and tachycardic response to intubation in a controlled randomized double-blind study in patients undergoing surgical procedures under general anesthesia. Forty adult patients were divided into four groups of 10 each: placebo (saline), lidocaine 100 mg, labetalol 5 mg, or labetalol 10 mg. The double-blind preparation was administered as an IV bolus just prior to induction and 2 min before the stimulus of laryngoscopy and intubation. Heart rate and blood pressure were measured at 1-min intervals for 2 min prior to induction of anesthesia and through 6 min following induction of anesthesia. Labetalol 10 mg prevented a rise in heart rate after intubation compared to patients who received placebo, lidocaine 100 mg, or labetalol 5 mg. The hypertensive response to intubation was similar in all four groups. Labetalol 10 mg IV just prior to induction of anesthesia is a safe and cost-effective means of preventing tachycardia but not hypertension in response to laryngoscopy and intubation.
authors.affiliation: Department of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
authors.forename: E
authors.initials: E
authors.lastname: Inada
authors.forename: D J
authors.initials: DJ
authors.lastname: Cullen
authors.forename: A R
authors.initials: AR
authors.lastname: Nemeskal
authors.forename: R
authors.initials: R
authors.lastname: Teplick
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007741:Labetalol / Q000008:administration & dosage / Q000494:pharmacology*; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D013514:Surgical Procedures, Operative; D013610:Tachycardia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D008012:Lidocaine; D007741:Labetalol