The Use of Esmolol, Nicardipine, or Their Combination to Blunt Hemodynamic Changes After Laryngoscopy and Tracheal Intubation

Atlee, John L.; Dhamee, M. Saeed; Olund, Timothy J.; George, Varghese

doi:10.1213/00000539-200002000-00008

Cited by 47 publications

(15 citation statements)

References 34 publications

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“…[14][15][16] The use of 5 µg·kg -1 of fentanyl together with inhalational anesthesia can blunt the cardiovascular responses to intubation. 17,18 In spite of similar maneuvers in both groups we obtained a significant and similar increase in MAP and HR with both techniques, reinforcing our belief that direct laryngoscopy and lightwand intubation behave similarly in this clinical setting.…”

Section: Me Et Th Ho Od Ds Smentioning

confidence: 99%

L’intubation endotrachéale avec stylet lumineux ou laryngoscope produit des variations hémodynamiques comparables chez des malades atteints de cardiopathie ischémique

Móntes

Giraldo

Betancur

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To asses the cardiovascular changes after either lightwand or conventional laryngoscopic endotracheal intubation (EI) in patients with coronary artery disease.M Me et th ho od ds s: : Following Institutional approval and informed consent, 80 consecutive patients undergoing elective coronary artery bypass grafting were enrolled in this prospective, controlled, single-blinded study. General anesthesia was induced with fentanyl 5 µ·kg -1 and thiopental 5 mg·kg -1 followed by pancuronium 0.1 mg·kg -1 . After loss-of-eyelash reflex the lungs were manually ventilated with 2% isoflurane in oxygen for five minutes. Patients were then randomly allocated to receive either the lightwand (lightwand group, n = 41) or direct-vision laryngoscopy (laryngoscopy group, n = 39). Heart rate (HR) and direct blood pressure were recorded before induction, after induction but before EI, during EI, immediately after EI and at ten-second intervals for the following five minutes. Hemodynamic management during induction was standardized. Hypotension was treated with volume replacement, ephedrine, or phenylephrine as indicated; hypertension was treated with iv nitroglycerin; tachycardia was treated with boluses of esmolol; and, bradycardia was treated with atropine or ephedrine.

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Section: Me Et Th Ho Od Ds Smentioning

confidence: 99%

L’intubation endotrachéale avec stylet lumineux ou laryngoscope produit des variations hémodynamiques comparables chez des malades atteints de cardiopathie ischémique

Móntes

Giraldo

Betancur

et al. 2003

Can J Anesth/J Can Anesth

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“…A variety of interventions [1][2][3][4][5][6] have been examined as possible stabilisers of the cardiovascular response, but none of these interventions have resulted in stable induction of anaesthesia because of either the inadequacy of their effect or unwanted sideeffects. It would be of great help if we could predict the haemodynamic response to induction of general anaesthesia.…”

mentioning

confidence: 99%

Correlation between heart rate variability and haemodynamic fluctuation during induction of general anaesthesia: comparison between linear and non‐linear analysis*

et al. 2007

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SummaryThe objective of this study was to compare linear and non-linear analysis of heart rate variability (HRV) in terms of correlation with haemodynamic fluctuation during induction of general anaesthesia. Pre-operatively, HRV was estimated by the MemCalc method in 114 patients scheduled for general anaesthesia. After anaesthesia was induced with propofol, fentanyl and vecuronium bromide, tracheal intubation was performed. Haemodynamic fluctuations during induction of anaesthesia were recorded and the correlation between pre-operative HRV and haemodynamic fluctuation was examined using logistic regression analysis. As an index of non-linear analysis of HRV, ultra short-term entropy (UsEn) correlated better with blood pressure fluctuation than did the ratio of the power of low frequency component of HRV to that of high frequency component (LF ⁄ HF). In contrast, although LF ⁄ HF significantly correlated with heart rate increase caused by tracheal intubation, the correlation between UsEn and heart rate fluctuation was not significant. Recently, some investigators have found linear analysis of heart rate variability (HRV) to predict the incidence of hypotension caused by induction of general [7] or spinal anaesthesia [8,9]. While frequency-domain measures of HRV, such as spectral analysis, focus on the status of cardiac autonomic activity, it is proposed that non-linear indices may provide insight into the overall structure of the heart rate regulating system. Although it was reported that pre-operative point dimension correlation (PD2), as a non-linear index of HRV, predicted hypotension after spinal anaesthesia [10], there is no previous report examining the correlation between non-linear index of HRV and circulatory response to induction of general anaesthesia.The MemCalc method, which is a combination of the maximum entropy method for spectral analysis and the non-linear least squares method for fitting analysis (Tarawa, Suwa Trust, Tokyo, Japan), has recently been developed [11,12]. This method enables us to estimate reliable HRV from a series of RR intervals over 30 s and recognises the abnormal RR interval of premature beats or artefacts, including noise, and removes it automatically. The MemCalc method does not cause distortion of the power calculation even if the underlying variation is changed, e.g. a change in respiration. When compared to

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“…However, the shape of the stylet may hinder its removal and cause longer intubation times. In addition, a recent study showed that intubation times with video laryngoscopes can be decreased with proper preparation of the stylet and tracheal tube (7,27 Various studies indicated that laryngoscopy may cause an undesirable increase in blood pressure and heart rate in anesthetized patients (29)(30)(31)(32)(33)(34)(35). Various video laryngoscopes have been studied to elucidate the hemodynamic changes during orotracheal intubation; however, there has been no study comparing the hemodynamic response to orotracheal intubation of the McGrath Series 5 video laryngoscope and the Macintosh laryngoscope (36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

Aydın

Çakmakçı

2014

Turk J Med Sci

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The utilisation of whey is very important for preventing the waste of a protein-and lactose-rich dairy by product and protecting the environment. Therefore, the objective of this study was to investigate the effect of whey use in tel (wire) kadayıf (a Turkish dessert raw material) production on microbiological and technological properties and sensory characteristics of tel kadayıf. For this purpose, 3 experimental tel kadayıf samples were produced using different amounts (0%, 25%, and 50%) of fresh whey instead of water in the production of raw tel kadayıf. The samples were placed in plastic bags and vacuum packaging and stored in a refrigerator (4 °C). Storage period (1, 3, 5, and 7 days) analysis was performed. The results of the research showed that nutritional value and sweetness increased, while the baking time decreased with respect to increases in the amount of whey used in tel kadayıf. As a result of a collective evaluation of the study findings, it was concluded that a 25% whey addition and vacuum packaging would provide the most positive quality characteristics in tel kadayıf desserts.

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The Use of Esmolol, Nicardipine, or Their Combination to Blunt Hemodynamic Changes After Laryngoscopy and Tracheal Intubation

Cited by 47 publications

References 34 publications

L’intubation endotrachéale avec stylet lumineux ou laryngoscope produit des variations hémodynamiques comparables chez des malades atteints de cardiopathie ischémique

L’intubation endotrachéale avec stylet lumineux ou laryngoscope produit des variations hémodynamiques comparables chez des malades atteints de cardiopathie ischémique

Correlation between heart rate variability and haemodynamic fluctuation during induction of general anaesthesia: comparison between linear and non‐linear analysis*

The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

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