[Comparison of lidocaine and urapidil for prevention of hemodynamic response to tracheal intubation in patients in general good health].
OBJECTIVE
To compare the efficacy of endovenous administration of 0.5 mg/kg-1 of urapidil to 1 mg/kg-1 of lidocaine for attenuating hemodynamic response to laryngoscopy and tracheal intubation.


METHODS
Study of 40 ASA I and II patients with normal blood pressure undergoing elective surgery under general anesthesia with orotracheal intubation. The patients were randomly assigned to two groups to receive either 0.5 mg/kg-1 of urapidil or 1 mg/kg-1 five minutes before anesthetic induction. Anesthesia was provided with 0.04 mg/kg-1 of midazolam, 2 micrograms/kg-1 of fentanyl, 2 mg/kg-1 of propofol, 0.1 mg/kg-1 of vecuronium before proceeding to orotracheal intubation, after electromyographic determination of neuromuscular response with T1 less than 5%, and laryngoscopy. Heart rate, systolic, diastolic and mean pressures, and the product of heart rate and mean arterial pressure (HR x MAP) were recorded at the following times: baseline (before administering either lidocaine or urapidil), after induction, after laryngoscopy and intubation, and 3 minutes and 5 minutes after intubation.


RESULTS
ASA classification, age, sex and weight were similar in the two groups. Heart rate immediately after intubation, and after 3 and 5 minutes was significantly lower in the lidocaine group. Likewise HR x MAP immediately after intubation and 3 minutes later was significantly lower in the patients who received lidocaine.


CONCLUSIONS
In healthy ASA I and II patients with normal blood pressure, a dose of 1 mg/kg-1 of lidocaine provided better protection against the hemodynamic response to laryngoscopy and tracheal intubation than does 0.5 mg/kg-1 of urapidil.
Santiveri
X
X
Servicio de Anestesiología y Reanimación, Hospital Universitario de Girona Dr. Josep Trueta.
Ledesma
M
M
Delás
F
F
García
C
C
Vilaplana
J
J
Villalonga
A
A
D000328:Adult; D000771:Anesthesia, Intravenous; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D010879:Piperazines; D014665:Vasodilator Agents
D000779:Anesthetics, Local; D010879:Piperazines; D014665:Vasodilator Agents; D008012:Lidocaine; C015568:urapidil