Clinical studies on the effect of various drugs on cardiocirculatory behavior during the induction phase of intubation anesthesia
Fösel, T.; Becker, M.; Dick, W.; Engels, K.; Mehrkens, H.H.; Taud, H.
Der Anaesthesist 32(12): 567-575
1983
ISSN/ISBN: 0003-2417 PMID: 6670732 Document Number: 198185
In a randomized study on 150 patients (ASA 1) undergoing induction of anaesthesia, the effects of Fentanyl (0.1 mg), the combination of Fentanyl (0.1 mg) and Droperidol (5 mg) (Innovar, Thalamonal) and Atropine (0.01 mg/kg b.w.) alone on cardiocirculatory parameters were studied. Induction and intubation were carried out with Thiopentone and Succinylcholine. All patients were aged between 18 and 50 years. In addition to continuous ECG recording of standard leads I-III, blood pressure measurements (Riva-Rocci), capillary blood gases and serum potassium were estimated at regular intervals. Prior to intubation Atropine caused arrhythmias in 10% and during intubation in 40%, half of which occurred repeatedly. In comparison, the control group showed arrhythmias in only 28% at intubation time. The median value of the rate pressure products rose before intubation time to levels of almost 20,000 units whereas the control group reached the same high product only during intubation. Cardiac rhythm proved most stable using Fentanyl, the systolic, diastolic and mean blood pressure changes were significantly lower than in those groups without an additional analgesic. With Fentanyl and Atropine the increase of all haemodynamic parameters was less pronounced than in the control group given Atropine only. Comparison of the Fentanyl groups showed only a significantly lower arterial mean pressure when Atropine was given, the other parameters were similar. Using Innovar alone, 4 cases of severe and 1 of mild rhythm disturbances appeared, while with Innovar plus Atropine only 2 cases of mild and 1 of repeated extrasystoles occurred. In the Atropine-free groups, the addition of Innovar only caused a lesser increase in the heart rate, while the remaining parameters did not differ.