title: Heart rate and blood pressure effects of esmolol after ketamine induction and intubation.
abstract: Both ketamine and tracheal intubation are associated with increased heart rate (HR) and systolic blood pressure (SBP). Beta blockers prevent or attenuate this increase. Esmolol (E) is a new, intravenous, rapidly metabolized beta blocker. An open-label study was performed in 41 ASA Class II and III patients divided into groups 1-4: control, 100, 200, and 300 micrograms X kg-1 X min-1 (n = 10, 10, 11, and 10, respectively). E was infused over 10 min, the first one-fourth of which was a loading dose of 500 micrograms X kg-1 X min-1; at 4 min, ketamine was followed by succinylcholine, intubation, and enflurane-N2O-O2. HR, SBP, blood E, and plasma catecholamine levels were obtained during the 40 min of study. The control group had a baseline HR of 83 +/- 5 beats/min while esmolol groups 2-4 had an HR of 73 +/- 3, 72 +/- 3, and 68 +/- 4 beats/min, respectively (P less than 0.05). After ketamine, the control group HR increased to 93 +/- 6 beats/min and groups 2-4 remained at the baseline level, 73 +/- 3, 73 +/- 3 and 67 +/- 4 beats/min, respectively (P less than 0.05). Postintubation, the control increased further to 113 +/- 5 beats/min while groups 2-4 were significantly less, 91 +/- 5, 84 +/- 3, and 78 +/- 4 beats/min, respectively. The mean SBP in most E groups was less than the control within groups, but only in group 4 between groups was the SBP less at postintubation (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000758:Anesthesia; D001794:Blood Pressure / Q000187:drug effects*; D002851:Chromatography, High Pressure Liquid; D004562:Electrocardiography; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D007649:Ketamine; D008875:Middle Aged; D011412:Propanolamines / Q000097:blood / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D011412:Propanolamines; D007649:Ketamine; C036604:esmolol