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RETRACTED ARTICLE: Diltiazem-lidocaine combination for the attenuation of cardiovascular responses to tracheal intubation in hypertensive patients

  • Yoshitaka Fujii
  • Yuhji Saitoh
  • Shinji Takahashi
  • Hidenori Toyooka
Reports of Investigation

Abstract

Purpose

Hypertensive patients are prone to haemodynamic changes after laryngoscopy and tracheal intubation. This study was undertaken to compare the efficacy of a combination of diltiazem and lidocaine with that of each drug alone for suppressing the cardiovascular responses to trachéal intubation.

Methods

Sixty hypertensive patients (ASA II), defined as systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 95 mmHg (World Health Organization), undergoing elective surgery received, in a randomized, double-blind manner, 0.3 mg·kg−1 diltiazem, 1.5 mg·kg−1 lidocaine, or 0.3 mg·kg−1 diltiazem plus 1.5 mg·kg−1 lidocaineiv (n = 20 of each) before the initiation of laryngoscopy. Anaesthesia was induced with 5 mg·kg−1 thiopentoneiv, and tracheal intubation was facilitated with 2 mg·kg−1 succinylcholineiv after precurarization with 0.02 mg·kg−1 vecuroniumiv. Changes in heart rate (HR), mean arterial pressure (MAP) and rate-pressure product (RPP) were measured before and at immediate, 1, 2, 3, 5 and 10 min after tracheal intubation.

Results

The inhibitory effects of diltiazem-lidocaine combination on cardiovascular responses to tracheal intubation was greater than those of diltiazem or lidocaine as a sole medicine (RPP; 10602 ± 1448 (combination)vs 11787 ± 1345 (diltiazem), 15428 ± 1756 (lidocaine), mean ± SD,P < 0.05).

Conclusion

Prophylactic therapy with diltiazem-lidocaine combination is more effective than diltiazem or lidocaine alone for attenuating the cardiovascular changes associated with tracheal intubation in hypertensive patients.

Keywords

Lidocaine Hypertensive Patient Mean Arterial Pressure Diltiazem Tracheal Intubation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Les patients hypertendus sont exposés à des changements hémodynamiques à la suite d’une laryngoscopie et d’une intubation endotrachéale. La présente étude avait pour but de comparer l’efficacité d’une combinaison de diltiazem et de lidocaïne avec celle de chaque médicament employé seul pour supprimer les réactions cardiovasculaires à l’intubation endotrachéale.

Méthode

Soixante patients hypertendus (ASA II), c’est-à-dire présentant une tension artérielle systolique > 160 mmHg et/ou une tension artérielle diastolique > 95 mmHg (Organisation mondiale de la Santé), devant subir une chirurgie élective, ont reçu au hasard et en double aveugle 0,3 mg·kg−1 de diltiazem, 1,5 mg·kg−1 de lidocaïne ou 0,3 mg·kg−1 de diltiazem avec 1,5 mg·kg−1 de lidocaïneiv (dans chaque groupe n = 20) avant de procéder à la laryngoscopie. Linduction de l’anesthésie s’est faite avec 5 mg·kg−1 de thiopentaliv, et l’intubation endotrachéale a été facilitée par l’administration de 2 mg·kg−1 de succinylcholineiv après la précurarisation en utilisant 0,02 mg·kg−1 de vécuroniumiv. Les changements de fréquence cardiaque (FC), de tension artérielle moyenne (TAM) et de produit de la fréquence par la tension (PFT) ont été mesurés avant et immédiatement après l’intubation endotrachéale, puis à 1, 2, 3, S et 10 min.

Résultats

Les effets inhibiteurs de la combinaison de diltiazem et de lidocaïne sur les réactions cardiovasculaires à l’intubation endotrachéale ont été plus importants que ceux du diltiazem ou de la lidocaïne employés seuls (PFT; 10602 ± 1448 (combinaison)vs 11787 ± 1345 (diltiazem), 15428 ± 1756 (lidocaïne), moyenne ± écarttype,P < 0,05).

Conclusion

La thérapie prophylactique à base d’une combinaison de diltiazem et de lidocaïne est plus efficace que le diltiazem ou la lidocaïne employés seuls pour atténuer les changements cardiovasculaires associés à l’intubation endotrachéale chez les patients hypertendus.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Yoshitaka Fujii
    • 1
  • Yuhji Saitoh
    • 2
  • Shinji Takahashi
    • 3
  • Hidenori Toyooka
    • 1
  1. 1.Department of AnaesthesiologyUniversity of Tsukuba Institute of Clinical MedicineIbarakiJapan
  2. 2.Department of Anaesthesiology and Critical Care MedicineTokyo Medical and Dental University School of MedicineTokyoJapan
  3. 3.Department of AnaesthesiologyTsukuba Gakuen HospitalIbarakiJapan

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