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RETRACTED ARTICLE: Combined diltiazem and lidocaine reduces cardiovascular responses to tracheal extubation and anesthesia emergence in hypertensive patients

Abstract

Purpose

Hypertensive patients exhibit exaggerated cardiovascular responses to tracheal extubation. This study was undertaken to compare the efficacy of combined diltiazem and lidocaine with each drug alone in suppressing the hemodynamic changes during tracheal extubation.

Methods

Sixty hypertensive patients (ASA II), defined as systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 95 mmHg (WHO), undergoing elective orthopedic surgery received, in a randomized, double-blind manner, 0.2 mg·kg−1 diltiazem, 1.0 mg·kg−1 lidocaine, or 0.2 mg·kg−1 diltiazem plus 1.0 mg·kg−1 lidocaine (n=20 of each) iv before tracheal extubation. Changes in heart rate (HR), mean arterial pressure (MAP) and ratepressure product (RPP) were measured before and after tracheal extubation.

Results

Hemodynamic changes during tracheal extubation were less in patients receiving diltiazem plus lidocaine than in those receiving diltiazem or lidocaine as a sole medicine (RPP; 10322 ±1674 (combined) vs 11532 ±1802 (diltiazem), 15388 ±2050 (lidocaine), mean ±SD, P < 0.05).

Conclusion

Combined diltiazem and lidocaine is more effective prophylaxis than diltiazem or lidocaine alone for attenuating the cardiovascular responses to tracheal extubation and emergence from anesthesia in hypertensive patients.

Résumé

Objectif

Les patients hypertendus présentent des réactions exagérées à l’extubation endotrachéale. L’étude a été réalisée pour comparer l’efficacité d’une combinaison de diltiazem et de lidocaïne avec chacun des médicaments utilisé seul, quant à la suppression de changements hémodynamiques pendant l’extubation endotrachéale.

Méthode

Soixante patients hypertendus (ASA II), ayant une tension artérielle systolique > 160 mmHg et/ou une tension artérielle diastolique > 95 mmHg (OMS), et devant subir une intervention élective en orthopédie, ont reçu de façon aléatoire et en double aveugle 0,2 mg·kg−1 de diltiazem, 1,0 mg·kg−1 de lidocaïne, ou 0,2 mg·kg−1 de diltiazem plus 1,0 mg·kg−1 de lidocaïne (n=20 dans chaque groupe) iv avant l’extubation endotrachéale. Les changements de fréquence cardiaque (FC), de tension artérielle moyenne (TAM) et du produit de la tension systolique par la fréquence des contractions cardiaques (PTF) ont été mesurés avant et après l’extubation.

Résultats

Les changements hémodynamiques ont été moindres chez les patients qui ont reçu les deux médicaments que chez ceux qui n’ont reçu que le diltiazem ou la lidocaïne seulement (PTF; 10322 ±1674 (combiné) vs 11532 ±1802 (diltiazem), 15388 ±2050 (lidocaïne), moyenne ±écart type, P < 0,05).

Conclusion

Une combinaison de diltiazem et de lidocaïne constitue une prophylaxie plus efficace que chaque médicament utilisé seul pour diminuer les réactions cardiovasculaires à l’extubation endotrachéale et à la récupération de l’anesthésie chez les patients hypertendus.

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Author information

Correspondence to Yoshitaka Fujii.

Additional information

A retraction note to this article is available at http://dx.doi.org/10.1007/s12630-013-9956-0.

This article has been retracted due to two reasons: Many variables reported in the studies are exceedingly unlikely. The author's institution is not able to attest to the integrity of the study and/or the data conducted under its auspices.

An erratum to this article is available at http://dx.doi.org/10.1007/s12630-013-9956-0.

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Fujii, Y., Saitoh, Y., Takahashi, S. et al. RETRACTED ARTICLE: Combined diltiazem and lidocaine reduces cardiovascular responses to tracheal extubation and anesthesia emergence in hypertensive patients. Can J Anesth/J Can Anesth 46, 952 (1999). https://doi.org/10.1007/BF03013130

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Keywords

  • Lidocaine
  • Hypertensive Patient
  • Mean Arterial Pressure
  • Diltiazem
  • Tracheal Intubation