Electrocardiographic Findings During Laryngoscopy and Endotracheal Intubation

Horton, J. A. G.

doi:10.1016/s0007-0912(17)44350-9

Cited by 6 publications

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“…As with the injection of SCh in standard apnoeic doses, these circulatory changes are a rise in the arterial blood pressure, cardiac arrhythmia, and an increase in the peripheral blood flow, especially in the limbs (126). However, in contrast to SCh, endotracheal intubation also induces an increased vascular resistance in the limbs (the increase in the limb blood flow is only pressure-passive) and a marked tachycardia (126); especially the latter demonstrates an effect opposite to that of SCh (157).…”

Section: B F a C T O R S W H I C H Can I N T E R F E R E W I T H C Imentioning

confidence: 99%

Circulatory Effects of Succinylcholine in Man

Gräf

Ström

Wåhlin

1963

Acta Anaesthesiol Scand

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SUMMARY The effects of intravenous (standard apnoeic) and intra‐arterial doses of succinylcholinc chloride (SCh) on peripheral circulation (forearm, hand, skeletal musculature, skin, mucosa of the sigmoid colon), arterial blood pressure and heart rate were studied in 15 unanaesthetized and 17 anaesthetized subjects. Standard apnoeic doses of SCh injected intravenously in anaesthetized subjects produced circulatory changes usually of a biphasic character, a sudden initial decrease in peripheral blood flow and heart rate followed by an increase throughout The apnoeic period; there was also a rise in arterial blood pressure. The initial decrease occurred synchronously with the preparalytic activity of the skeletal musculature (twitchings), but unlike the latter also after repeated injections of SCh. The magnitude of the initial decrease was, on an average, 16 per cent for the peripheral circulation, and 7 per cent for heart rate. The subsequent average increase amounted to 16 per cent above the initial control value for the peripheral circulation, 8 per cent (5 mm Hg) for the systolic, 21 per cent (6 mm Hg) for the diastolic and 9 per cent (4 mm Hg) for the mean arterial blood pressures. Doses of SCh which caused local muscular relaxation on continuous infusion into the brachial artery of unanaesthetized subjects also caused an average blood flow increase in forearm and hand of 43 per cent. This blood flow response remained only during the first few minutes, and then gradually decreased to the control level during the course of the next 10–15 minutes. After the second or third repeated intravenous injection of SCh, but not after further injections, a sudden and marked bradycardia sometimes occurred, with a duration of up to 3 minutes. With repeated intravenous injections of SCh in a standard apnoeic dose, the size and duration of both the circulatory reactions and the duration of the apnoeic period gradually decreased (‘tachyphylaxis’). The individual sensitivity to SCh was rather variable. This was particularly evident in patients with a labile and hyperkinetic circulation (‘vasoregulatory asthenia’) in whom the average blood flow increase during continuous intra‐arterial infusion of SCh was considerably higher than in the control group. The circulatory changes after an intravenous injection of an apnoeic SCh dose should be evaluated in relation to the various interfering factors, such as anaesthesia, atropine premedication, endotracheal intubation, positive‐pressure ventilation, hypoxia, hypercapnia, hypothermia during anaesthesia, and acidosis. The possible mechanisms by which SCh exerts its circulatory effects are discussed, especially the direct effects on the vessels and heart and the indirect effects via nervous or humoral mediators. It is concluded that SCh seems to be a general vasodilator substance. A review of the literature shows that the vasodilator effect of SCh also exists in circulatory areas of the body not directly studied in the present investigation. The vasodilatation is partially caused by a ...

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Section: B F a C T O R S W H I C H Can I N T E R F E R E W I T H C Imentioning

confidence: 99%

Circulatory Effects of Succinylcholine in Man

Gräf

Ström

Wåhlin

1963

Acta Anaesthesiol Scand

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“…In an ex.g. study of 219 patients undergoing surgical anaesthesia with various agents the most common sequel to intubation was tachycardia (Horton, 1955). This occurred in 181 cases, in 3 there was no change and in the remaining 35 there was slowing of the pulse rate.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic Studies During Endotracheal Intubation and Inflation of the Cuff

Rollason

Hough

1957

British Journal of Anaesthesia

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Atropine and the electrical activity of the heart during induction of anaesthesia in children

Sagarminaga

Wynands

1963

Canad. Anaes. Soc. J.

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Tim I~OLE OF Pm~lVrEDICATION in the incidence and sewritv of cardiac arrhythlnias during induction of anaesthesia has received lithe attention. Although many authors ~-~s have made recommendations regardingl premedieation and its value in the prevention of arrhythmias, only a few 346,1~ have attempted to study this problem systematically.The aetiology of cardiac arrhythmias and catastr0phes during induction and maintenance of anaesthesia has been studied extensiyely 10-54 since John Snow 19 first reported in 1858 off cardiac arrest occurring d] tring induction of anaesthesia with chloroform. Following this first report, the rela ti~e importai~ce of the sympathetic and parasympathetic nervous systems has 1 een the subject of numerous investigations. Many authors2,6.s.9,~,XS,lS, ~~ ha~ e pointed to the role o~ the parasympathetic system in the aetiology of these ar hythrnias. On the other hand, other authors 4,5,ag,lr,zl-24,35,ss-4a starting with the fi~st reports by Levy 2s have I attributed the disturbances in cardiac rhythm to increased activity of the sympathetic nervous system. The effects of other factors such as hypoxia, hypercarbia, acidosis, and sensitization of the myocardium have also received considerable attention. 4,5,12,9`s,a~ Earlier studies were mainly concerned with chloroform, cyclopropane, and trichloroethylene mias have been adequately documented.The exact disturbances in electrical activity of sympathetic and sympathetic stimulation have and reported. ~5-7~ The pharmacology, advgntages administration of atropine have also been well stud]With this background we decided to do a sys :o circulating eatecholamines ~86,41,44,46,48-77 trrhythmias occurring during naesthesia. 5~ These arrhyththe heart produced by parabeen thoroughly investigated , and possible dangers of the ed.XS,~ S,TS-S5 ernatic study of the 'electrical activity of the heart during ind(tction of anaesth~ sxa in children. We wished to determine the incidence and aetiology of cardiac ~-'~egularities when anaesthesia I ~ 9 9 9was induced by the techniques commonly used inlo .ur hospital. The possibility of preventing or abolishing these arrhythmias natu~rally followed the completion of the primary purpose of the paper.MATErnAL AND METHODS One hundred and seventy-five inductions of an years of age were studied by means of a continue of the electrocardiogram. A recording was taker~ to induction until the child was being v~ prior intubafion. The sedative effect of the premedi~ *Department of Anaesthesia, Royal Victoria Hospital, Nil 328 aesthesia in children under te~ us-recording, standard Lead I~ continuously from immediately ltilated following endotrachea 1 tion permitted the application mtreal, Quebec.

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Electrocardiographic Findings During Laryngoscopy and Endotracheal Intubation

Cited by 6 publications

References 0 publications

Circulatory Effects of Succinylcholine in Man

Circulatory Effects of Succinylcholine in Man

Electrocardiographic Studies During Endotracheal Intubation and Inflation of the Cuff

Atropine and the electrical activity of the heart during induction of anaesthesia in children

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