Haemodynamic and plasma catecholamine responses during total intravenous anaesthesia for laryngomicroscopy

Mustola, Seppo; Baer, Gerhard; Metsä‐Ketelä, T.; Laippala, Pékka

doi:10.1111/j.1365-2044.1995.tb15090.x

Cited by 37 publications

(20 citation statements)

References 25 publications

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“…Propofol causes a greater reduction in cardiac output 142 [II], cardiac index and systemic vascular resistance 143,144 [II]. After intubation, a more marked increase of arterial blood pressure and heart rate is seen in several studies following thiopentone administration [145][146][147][148] [II, III]. Thiopentone leads to increased levels of plasma adrenaline 137 and plasma noradrenaline.…”

Section: Thiopentone and Propofolmentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

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Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high‐grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients should be given by, or under very close supervision by, experienced anaesthesiologists. Problems with the airway and the circulation must be anticipated. The risk of aspiration must be judged for each patient. Pre‐operative gastric emptying is rarely indicated. For pre‐oxygenation, either tidal volume breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre‐oxygenation in the obese patients should be performed in the head‐up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1–1.5 mg/kg is preferred. Outside the operation room, rapid sequence intubation is also considered the safest method. For all patients, precautions to avoid aspiration and other complications must also be considered at the end of anaesthesia.

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Section: Thiopentone and Propofolmentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

View full text Add to dashboard Cite

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“…This causes marked cardiovascular responses via irritation of the deep sensory receptors of the larynx [1,2]. An increase of arterial pressure and heart rate caused by suspension laryngoscopy are usually temporary and rarely accompanied by sequelae [3].…”

Section: Introductionmentioning

confidence: 99%

Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation

Lee

Park

2011

Korean J Anesthesiol

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BackgroundIt is well known that suspension laryngoscopy (SL) produces marked hemodynamic changes. Coughing during extubation sometimes causes adverse clinical problems. We investigated whether 10% lidocaine spray could attenuate hemodynamic stress responses due to SL and reduce coughing incidence during extubation.MethodsSixty patients undergoing SL were randomly divided into two groups and intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine, sprayed onto laryngeal and intratracheal sites 2 min prior to intubation (10% lidocaine group). Mean arterial pressure (MAP) and heart rates (HR) during SL and coughing incidence during extubation were recorded.ResultsMAP at 2.5 and 5 min (P < 0.05) and HR at 2.5 min after SL (P < 0.01) were greater in the control group than in the 10% lidocaine group. The number of coughs decreased in the 10% lidocaine group compared to the control group during pre- (6.8 ± 3.2 vs 10.3 ± 4.4, P < 0.01) and post-extubation period of 5 min (4.0 ± 2.3 vs 6.2 ± 4.2, P < 0.05) and during the entire study period (10.8 ± 3.9 vs 16.5 ± 5.6, P < 0.001).ConclusionsPreoperative laryngeal and intratracheal spraying with 1.5 mg/kg of 10% lidocaine spray is effective for attenuation of arterial pressure increase to SL and suppression of coughing during extubation.

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“…Notably, because both sevofl urane and isofl urane augment the sympathetic response [13], it is best to use small amounts of these agents. Another option is the continuous infusion of propofol, which suppresses the sympathomimetic effect to an even greater degree [14]. To treat tachycardia, it is important to maintain circulating blood volume with suffi cient fl uid and blood infusion, and also to correct electrolyte imbalance.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole

Matsumoto¹,

Shingu²,

Hidaka³

et al. 2009

J Anesth

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Secondary hyperthyroidism can often complicate gestational trophoblastic disease, a malignant uterine cancer. We report here the perioperative management of hyperthyroidism due to hydatidiform mole. A 53-year-old woman underwent emergency surgery due to suspicion of hydatidiform mole. Tachycardiac atrial fibrillation was detected by electrocardiography at the preoperative examination. No abnormalities were found in blood count, coagulation, biochemical tests, chest radiographs, or respiratory function. General anesthesia with nitrous oxide, oxygen, and sevoflurane, combined with fentanyl and 1% mepivacaine, was administered intermittently from an epidural catheter. Intraoperative events included hypotension and tachycardia, although in general, tachycardia was prevented with antiarrhythmic agents and transfusion with a plasma expander and crystalloid fluid. Hyperthyroidism was highly suspected from the patient's clinical course and was confirmed by high levels of preoperative serum free triiodothyronine (T3) and thyroxine (T4). The patient became euthyroid within a few days after mole evacuation and did not require an antiarrhythmic agent after her return to the inpatient ward.

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Haemodynamic and plasma catecholamine responses during total intravenous anaesthesia for laryngomicroscopy

Abstract: SummaryWe compared the haemodynamic responses to endolaryngeal procedures during anaesthesia with propofol or thiopentone. Two minures after administration of glycopyrroniurn 4pg.kg-' and alfentanil 17.5pg

Cited by 37 publications

References 25 publications

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation

Anesthetic management of a patient with hyperthyroidism due to hydatidiform mole

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