CATECHOLAMINE RESPONSE TO LARYNGOSCOPY AND INTUBATION - THE INFLUENCE OF 3 DIFFERENT DRUG-COMBINATIONS COMMONLY USED FOR INDUCTION OF ANESTHESIA

被引:26
作者
CHRAEMMERJORGENSEN, B
HERTEL, S
STROM, J
HOILUNDCARLSEN, PF
BJERREJEPSEN, K
机构
[1] UNIV COPENHAGEN,GLOSTRUP HOSP,DEPT CLIN PHYSIOL,DK-2600 GLOSTRUP,DENMARK
[2] UNIV COPENHAGEN,GLOSTRUP HOSP,DEPT NUCL MED,DK-2600 GLOSTRUP,DENMARK
关键词
SYMPATHETIC NERVOUS SYSTEM; CATECHOLAMINES; INTUBATION; TRACHEAL; COMPLICATIONS; ANESTHETICS; INTRAVENOUS; THIOPENTONE; MIDAZOLAM;
D O I
10.1111/j.1365-2044.1992.tb03252.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The haemodynamic response and changes in plasma catecholamine concentrations associated with laryngoscopy and tracheal intubation were compared during anaesthesia employing three strictly standardised techniques with commonly used drug combinations. Thirty‐six patients were investigated consecutively resulting in 12 patients in each of three study groups. Anaesthesia was induced with thiopentone 5 mg.kg−1 (group 1), fentanyl 6 ng.kg−1 with thiopentone 5 mg.kg−1 (group 2). or midazolam 0.2 mg.kg−1 with fentanyl 6 ug.kg−1 (group 3). Undesirable changes in haemodynamic effects and an elevation of plasma catecholamine concentrations during laryngoscopy and intubation occurred in group 1. Heart rate and mean arterial pressure increased significantly (34% and 23% respectively). Noradrenaline concentration increased by a maximum of 147%. The addition of fentanyl (groups 2 and 3) attenuated the adverse haemodynamic response and elevation of plasma catecholamine concentrations; heart rate and mean arterial pressure did not differ from pre‐intubation values and plasma catecholamine concentrations decreased steadily. Substitution of thiopentone by midazolam in combination with fentanyl abolished the adverse haemodynamic response and modified the increase in plasma catecholamine concentrations. ‘High‐dose’ opioid anaesthesia is not necessary to produce optimal conditions during laryngoscopy and intubation. Copyright © 1992, Wiley Blackwell. All rights reserved
引用
收藏
页码:750 / 756
页数:7
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