Key result
Continuous nicardipine infusion blunts blood pressure response during intubation vs. control but increases heart rate.
Why the study?
Laryngoscopy and tracheal intubation often induce undesirable increases in blood pressure and heart rate, and effective methods to prevent these hemodynamic responses are needed.
Does continuous nicardipine infusion prevent undesirable increases in blood pressure and heart rate during endotracheal intubation in normotensive adult patients?
RCT (n=60)
randomly allocated
No
Does continuous nicardipine infusion prevent undesirable increases in blood pressure and heart rate during endotracheal intubation in normotensive adult patients?
Continuous nicardipine infusion effectively blunts the pressor response to intubation but induces tachycardia, which warrants caution in patients with ischemic heart disease.
Blunts intubation-induced hypertension yet raises heart rate; extends vasodilator evidence while cautioning use in ischemic heart disease.
Background: Laryngoscopy and tracheal intubation often induced an undesirable increase in blood pressure and heart rate.We evaluated the preventing effect of nicardipine infusion on the increase of the blood pressure (BP) and heart rate (HR) following a direct laryngoscopy and tracheal intubation.Methods: Sixty, ASA physical status 1-2, adult patients were selected with informed consent, and randomly allocated into two groups; control group (n = 30) and nicardipine group (n = 30).In the control group, 1.8 ml/kg/h of normal saline was infused, and in the nicardipine group, 5μg/kg/min of nicardipine was infused continuously from 2 minutes before intubation to 3 minutes after intubation.BP and HR were measured by non-invasive method after arrival at the operating room, before tracheal intubation, shortly after tracheal intubation, and 1, 3, 5, and 10 minutes following intubation.Data were analyzed by repeated measure of ANOVA and t-test.Results: Systolic and diastolic BP were significantly lower in the nicardipine group than in the control group (P ＜ 0.05).HR showed significantly higher value in the nicardipine group (P ＜ 0.05). Conclusions:The continuous infusion of nicardipine (5μg/kg/min) was effectively attenuating an increase of BP during tracheal intubation.But the increase in HR is not blunted by nicardipine infusion and there is a significant increase in HR.Although rate-pressure product (RPP) does not increase, the use of nicardipine for blunting hemodynamic responses should be considered carefully in patients with ischemic heart disease.(Korean J Anesthesiol 2007; 53: 332～7)
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Kim et al. (2007) conducted an RCT in Hemodynamic response to endotracheal intubation (n=60). Nicardipine vs. Normal saline (1.8 ml/kg/h) was evaluated on Systolic and diastolic blood pressure and heart rate following direct laryngoscopy and tracheal intubation (p=<0.05). Continuous nicardipine infusion (5μg/kg/min) significantly reduced systolic and diastolic blood pressure but significantly increased heart rate compared to control during tracheal intubation.
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