[Effects of esmolol and fentanyl on the hemodynamic and catecholamine response to tracheal intubation in hypertensive patients].
OBJECTIVE
To compare effects of esmolol and fentanyl on the hemodynamic and catecholamine response to tracheal intubation in hypertensive patients.


METHODS
Sixty hypertensive patients were randomly allocated into one of four groups: the patients received 0.9% saline in group A, 2 mg/kg esmolol in group B, 2 microg/kg fentanyl in group C and 2 mg/kg esmolol combined with 2 microg/kg fentanyl in group D before intubation. Tracheal intubation was performed with 0.1 mg/kg midazolam, 0.6 mg/kg atracurium and 2 mg/kg propofol. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), heart rate (HR), rate-pressure product (RPP), plasma noradrenaline (NA) and adrenaline (A) concentrations were measured before and after intubation.


RESULTS
SAP, DAP, HR, RPP, NA and A levels in group A at 1 and 3 minutes after intubation were significantly higher than the baseline values (all P<0.01). NA levels in group B and SAP in group C increased significantly after intubation (both P<0.05). The hemodynamics and catecholamine in group D after intubation were not significantly different from the baselines (all P>0.05).


CONCLUSIONS
2 mg/kg esmolol or 2 microg/kg fentanyl can partly reduce hemodynamic response to intubation and 2 mg/kg esmolol combined with 2 microg/kg fentanyl can completely attenuate the hemodynamic and catecholamine response in hypertensive patients.
Cheng
Ming-hua
MH
Department of Anesthesiology, First Affiliated Hospital of Medical College, Shantou University, Shantou 515041, Guangdong, China.
Yao
Yong-ming
YM
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000032:analysis*; D005283:Fentanyl / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*
D002395:Catecholamines; D011412:Propanolamines; C036604:esmolol; D005283:Fentanyl