title: [Cardiovascular response to tracheal intubation in patients with intracranial tumor. Comparative study between urapidil and lidocaine].
abstract: OBJECTIVE
  To compare the effects of urapidil and lidocaine on cardiovascular response to laryngoscopy and tracheal intubation in patients with brain tumors.
  
  
  METHODS
  Prospective, randomized double-blind study of 40 ASA II-III patients undergoing elective surgery for supratentorial tumor resection. The patients were assigned to two groups of 20 to receive an intravenous bolus of 1.5 mg/kg of lidocaine or 0.4 mg/kg urapidil before laryngoscopy and intubation. Anesthetic induction was performed with 0.03 mg/kg midazolam, 3 micrograms/kg of fentanyl, 5 mg/kg of thiopental and 0.2 mg/kg of vecuronium. Anesthesia was maintained with N2O/O2 (60%/40%) and isoflurane (0.5% expired). The following variables were recorded: mean blood pressure, heart rate and arterial oxygen saturation (SpO2) at baseline and 1, 2 and 3 min after induction and at 1, 2, 3, 4, 5 and 10 min after laryngoscopy and tracheal intubation.
  
  
  RESULTS
  The two groups were comparable with respect to age, sex, weight, height and baseline hemodynamics. No statistically significant differences in hemodynamic variables were found between the two groups. Mean blood pressure in the postintubation period stayed near baseline and heart rate increased significantly after laryngoscopy and tracheal intubation in both groups. SpO2 decreased 7 min after administration of urapidil and stayed lower throughout the study period and was statistically different from SpO2 in the lidocaine group. All changes described were within clinically normal ranges.
  
  
  CONCLUSIONS
  In patients undergoing neurosurgery to remove a supratentorial tumor, both lidocaine and urapidil reduce the pressor response to laryngoscopy and tracheal intubation at the doses given in this study. However, neither was able to prevent the increase in heart rate.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, Murcia.
authors.forename: J
authors.initials: J
authors.lastname: Hernández-Palazón
authors.forename: J A
authors.initials: JA
authors.lastname: Tortosa Serrano
authors.forename: C
authors.initials: C
authors.lastname: García-Palenciano
authors.forename: E
authors.initials: E
authors.lastname: Molero Molero
authors.forename: S
authors.initials: S
authors.lastname: Burguillos López
authors.forename: D
authors.initials: D
authors.lastname: Pérez-Flores
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000494:pharmacology*; D008297:Male; D010879:Piperazines / Q000494:pharmacology*; D011446:Prospective Studies; D015173:Supratentorial Neoplasms / Q000503:physiopathology* / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D000959:Antihypertensive Agents; D010879:Piperazines; D008012:Lidocaine; C015568:urapidil