title: Attenuation of the cardiovascular and catecholamine responses to tracheal intubation with oral guanabenz.
abstract: We conducted a randomized, placebo-controlled, and double-blind study to evaluate the efficacy of oral guanabenz, an alpha 2-adrenergic agonist, in attenuating the cardiovascular and catecholamine responses to laryngoscopy and tracheal intubation in 30 normotensive (ASA physical status 1) patients undergoing elective surgery. They were allocated to one of three groups (n = 10 for each): placebo, 4 mg, or 6 mg of guanabenz groups. These tablets were administered 2 h before the induction of anesthesia. Anesthesia was induced with thiopental 5.0 mg/kg intravenously (IV), and tracheal intubation was facilitated by the administration of vecuronium, 0.2 mg/kg IV. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Laryngoscopy lasting 30 s was attempted 2 min after the administration of thiopental and vecuronium. Patients receiving placebo showed a significant increase in mean arterial blood pressure, heart rate, and plasma catecholamine concentrations in response to tracheal intubation. These changes were significantly smaller in patients receiving either dose of guanabenz (P < 0.05). Oral administration of guanabenz before induction of anesthesia is a simple and effective method for attenuating the pressor and tachycardic responses to laryngoscopy and tracheal intubation with the drug acting at least partly via inhibition of the increases in plasma catecholamines concentrations.
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: 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: K
authors.initials: K
authors.lastname: Nishina
authors.forename: H
authors.initials: H
authors.lastname: Obara
mesh_terms: D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000328:Adult; D003864:Depression, Chemical; D004311:Double-Blind Method; D004837:Epinephrine / Q000097:blood*; D005260:Female; D006143:Guanabenz / Q000008:administration & dosage*; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D009638:Norepinephrine / Q000097:blood*; D013514:Surgical Procedures, Operative
chemical_list: D000316:Adrenergic alpha-Agonists; D006143:Guanabenz; D009638:Norepinephrine; D004837:Epinephrine