Hemodynamic response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with different concentrations of sevoflurane.
OBJECTIVE
To evaluate the blood pressure (BP) and heart rate (HR) response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with four concentrations of sevoflurane followed by nitrous oxide (N2O) 50% and sevoflurane in concentrations administered by clinical judgment.


METHODS
Prospective, randomized study.


METHODS
University teaching hospital.


METHODS
60 unpremedicated, ASA physical status I and II adult patients undergoing surgery with general anesthesia.


METHODS
After fentanyl 3 micrograms/kg, VCRII was accomplished with four concentrations of sevoflurane in O2: Group 1 (n = 15): sevoflurane 3%; Group 2 (n = 15): sevoflurane 4%; Group 3 (n = 15): sevoflurane 5%; and Group 4 (n = 15): sevoflurane 6%. At loss of consciousness, rocuronium 0.6 mg/kg was given, and intubation was performed 90 seconds later. Thereafter, anesthesia continued with N2O 50% and sevoflurane.


RESULTS
BP and HR measurements were made at the ward (baseline), at loss of consciousness, and just prior to, and each minute after, tracheal intubation during a 5-minute period. The hemodynamic profile among groups was similar, with a slight hypertensive and tachycardic response to intubation.


CONCLUSIONS
VCRII with sevoflurane 3% to 6% following fentanyl 3 micrograms/kg can be considered for blunting the hemodynamic response to tracheal intubation in healthy patients.
Muñoz
H R
HR
Department of Anesthesiology, Catholic University School of Medicine, Santiago, Chile. hmunoz@med.puc.cl
González
J A
JA
Concha
M R
MR
Palma
M A
MA
D000328:Adult; D000732:Androstanols / Q000008:administration & dosage; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D003243:Consciousness / Q000187:drug effects; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D009609:Nitrous Oxide / Q000008:administration & dosage; D011446:Prospective Studies; D000077123:Rocuronium; D000077149:Sevoflurane; D013610:Tachycardia / Q000503:physiopathology; D013997:Time Factors; D014797:Vital Capacity
D000732:Androstanols; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D009609:Nitrous Oxide; D005283:Fentanyl; D000077123:Rocuronium