The Effect of Diltiazem on the Cardiovascular Response to Tracheal Intubation

Abstract

The eficacy of diltiazem in the attenuation ofthe cardiovascular response to laryngoscopy and tracheal intubation was studied in patients who received 0.2 or 0.3 mg/kg diltiazem 60 seconds before the start of laryngoscopy. These data were cornpared with a control group who received saline. Each group consisted of I0 patients who had elective surgery. Patients who received saline showed a sign$cant increase in mean arterial pressure and rate pressure product associated with tracheal intubation. These increases after tracheal intubation were reduced in diltiazem-treated patients compared with those of the control group (p < 0.0s). The data suggest that a bolus injection of diltiazem is a simple, practical and efective method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.

Effects of calcium channel blockers on circulatory response to tracheal intubation in hypertensive patients: nicardipine versus diltiazem

“…2 It has also been reported that MAP starts to decrease 20-40 sec after diltiazem /v administration and is maximal at 1.5 min. 4 The MAP begins to increase about 15 see after layrngoscopy and attains a maximum value at~r 30-45 see ff no pretreatment is given. 7 Thus,/v nicardipine or diltiazem should be given 60 see before laryngoscopy to attenuate the pressor responses in the present study.…”

A randomized, controlled study to compare the effects of intravenous labetalol and esmolol on haemodynamic changes during laryngoscopy and intubation

“…15,16 Different pharmacologic agents like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α and β adrenergic blockers, and opioids can be administered prior to tracheal intubation in order to prevent haemodynamic responses (Helfman et al; Mikawa et al). 4,17 In present study at baseline all the groups were matched for haemodynamic parameters and did not show a significant intergroup difference. However, immediately after injection of test drug (1 minute after test drug) both the test groups showed a significant decrease in SBP (systolic blood pressure) and heart rate.…”

Clinical efficacy of Esmolol, Lignocaine and Diltiazem as premedicant for attenuation of hemodynamic responses of laryngoscopy and endotracheal intubation- a comparative evaluation

“…8 Pharmacological measures using volatile anesthetics-to deepen the anaesthesia, topical or intravenous lignocaine opioid analgesics like fentanyl, magnesium sulphate, calcium channel blockers beta-blockers clonidine and vasodilators-sodium-nitroprusside, nitro-glycerine have been studied, but none of the above approaches have proved to be ideal due to their limitations and side effects. [9][10][11][12][13][14] Hence the search of an ideal agent to attenuate the hemodynamic responses of laryngoscopy and intubation is still continuing.…”