title: Partial attenuation of the cardiovascular responses to tracheal intubation with oral manidipine.
abstract: We conducted a placebo-controlled, randomized, and double-blinded study to evaluate the efficacy of manidipine given orally in attenuating the cardiovascular responses to laryngoscopy and tracheal intubation. Thirty normotensive patients (ASA physical status 1) undergoing elective surgery were allocated to one of three groups (n = 10 for each); placebo, 5 mg manidipine, and 10 mg manidipine groups. These tablets were orally administered 3 h before induction of anaesthesia. Anaesthesia was induced with thiopentone 5 mg.kg-1 iv, and tracheal intubation was facilitated with vecuronium 0.2 mg.kg-1. Laryngoscopy lasting 30 sec was attempted 2 min after induction of anaesthesia. Patients receiving placebo showed a significant increase in systolic and diastolic blood pressure associated with tracheal intubation. These increases following tracheal intubation were significantly reduced in patients receiving manidipine 10 mg compared with patients receiving placebo or manidipine 5 mg (P < 0.05). Oral administration of manidipine 10 mg before induction of anaesthesia is a simple and effective method for attenuating pressor response to laryngoscopy and tracheal intubation. We stressed that the potential beneficial effect of a reduced haemodynamic reaction to intubation might be obtained at the expense of hypotension later on.
authors.affiliation: Department of Anaesthesiology, Kobe University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mikawa
authors.forename: N
authors.initials: N
authors.lastname: Maekawa
authors.forename: K
authors.initials: K
authors.lastname: Nishina
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.forename: H
authors.initials: H
authors.lastname: Kaetsu
authors.forename: R
authors.initials: R
authors.lastname: Goto
authors.forename: H
authors.initials: H
authors.lastname: Yaku
authors.forename: Y
authors.initials: Y
authors.lastname: Takao
authors.forename: H
authors.initials: H
authors.lastname: Obara
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000771:Anesthesia, Intravenous; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology*; D004095:Dihydropyridines / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009578:Nitrobenzenes; D010879:Piperazines; D010919:Placebos; D013874:Thiopental; D014673:Vecuronium Bromide
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D009578:Nitrobenzenes; D010879:Piperazines; D010919:Placebos; C054218:manidipine; D014673:Vecuronium Bromide; D013874:Thiopental