Comparison of the effects of intravenous alfentanil and esmolol on the cardiovascular response to double-lumen endobronchial intubation.
We compared the effect of alfentanil 10 microg.kg-1 and esmolol 1.5 mg.kg-1 on the cardiovascular responses to laryngoscopy and double-lumen endobronchial intubation in two groups of 20 ASA 2-3 patients undergoing pulmonary surgery, in a randomised double-blind study. Arterial pressure and heart rate decreased after induction of anaesthesia and increased after intubation in both groups (p < 0.05) but remained at or below baseline values, and changes were comparable in both groups. Plasma catecholamine concentrations decreased after induction of anaesthesia in both groups (p < 0.05). Epinephrine concentrations increased in the esmolol group after intubation (p < 0.05) but remained below baseline in the alfentanil group (p < 0.05). Norepinephrine concentrations increased significantly in both groups after intubation but were higher in the esmolol group (p < 0.05). Although both esmolol 1.5 mg.kg-1 and alfentanil 10 microg.kg-1 similarly attenuated the arterial pressure and heart rate response to endobronchial intubation, plasma catecholamine concentrations increased in the esmolol group to values greater than previously reported after tracheal intubation.
Maguire
A
A
University Department of Anaesthesia, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Thompson
J P
JP
Guest
C
C
Sadler
P J
PJ
Strupish
J W
JW
West
K J
KJ
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000494:pharmacology*; D000701:Analgesics, Opioid / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008168:Lung / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011412:Propanolamines / Q000494:pharmacology*
D000319:Adrenergic beta-Antagonists; D000701:Analgesics, Opioid; D011412:Propanolamines; D015760:Alfentanil; C036604:esmolol; D009638:Norepinephrine; D004837:Epinephrine