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European Journal of General Medicine
Medical Investigations Society
ISSN: 1304-3897
Vol. 5, No. 4, 2008, pp. 198-207
Bioline Code: gm08040
Full paper language: English
Document type: Research Article
Document available free of charge

European Journal of General Medicine, Vol. 5, No. 4, 2008, pp. 198-207

 en Can Calcium And Sodium Channel Blockers Attenuate Hemodynamic Responses To Endotracheal Intubation?
Govindaiah, Manjunath Honnavara; Suryanarayana, Venkatesh Gubbi; Vas, Prima; Vlk, Jennifer Leigh & Chandra, Sathees Beladakere Channaiah


Aim: Direct laryngoscopy and endotracheal intubation following induction of anesthesia almost always triggers powerful cardiovascular responses. The purpose of this study was to investigate the efficacy of diltiazem (calcium channel blocker), lidocaine (sodium channel blocker) and a combination of these two drugs in the attenuation of circular responses to endotracheal intubation in normotensive patients.
Methods: 120 Patients were randomly assigned to one of the following four groups. Group I received a single 0.2 mg/kg IV bolus of diltiazem 1 minute prior to laryngoscopy and intubation (n=30), Group II received a single 1.5 mg/kg IV bolus of lidocaine (n=30) 3 minutes prior and Group III received combination of these two drugs 1 minute prior to laryngoscopy and intubation (n=30). Group IV served as the control and received a single 5 mL IV bolus of normal saline. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured and then compared within and between groups. Rate pressure product (RPP) was calculated and evaluated as well.
Results: Either diltiazem or lidocaine alone blunts unwanted hemodynamic responses to intubation. However, significantly less circulatory responses were experienced by patients receiving both than those receiving either lidocaine or diltiazem alone.
Conclusion: Given the difference in the pharmacological mechanisms of these two drugs, the prophylactic therapy with combination of diltiazem+lidocaine is significantly more effective than any one alone for attenuating hemodynamic changes to laryngoscopy and tracheal intubation, without producing increased risk of hypertension.

Calcium channel, sodium channel, circulatory response, endotracheal intubation, hemodynamic change

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