The selection of anesthesia induction agents with respect to intubation induced bradycardia
van Egmond, J.; Molema, A.J.; Nijhuis, G.M.; Lieverse, P.; Booij, L.H.
Acta Anaesthesiologica Belgica 37(2): 121-126
1986
ISSN/ISBN: 0001-5164 PMID: 3751477 Document Number: 282271
Brachycardia induced by minor displacements of electrodes is a rare but serious complication of intubation during surgery to prevent aspiration and to control breathing. This study compared the short-term effects of commonly used anesthetics on the heart rate before, during, and immediately after intubation. Research subjects included 50 patients 20-40 years of age who were scheduled for laparoscopy. Various combinations of the drugs Fentanyl, nicomorphin, etomidate, thiopentone, vercuronium, and succinyldicholine were investigated. Dangerously low heart rates (under 40/minute) were found during intubation when the drug combination for anesthesia induction was Fentanyl, etomidate, and succinyldicholine (FES) or Fentanyl, etomidate, and vercuronium (FEV). The decrease in heart rate during the complete induction-intubation procedure was most pronounced when FES was the drug combination used. The decrease of the heart rate caused directly by the intubation stimulus was also most marked after induction with FES. For the drug combinations FES, FEV, and nicomorphin, etomidate, and succinyldicholine (NES), heart rate decreased by induction of anesthesia alone, whereas heart rate increased with the nicomorphin, thiopentone, and succinyldicholine (NTS) combination. Since the drugs nicomorphine, thiopentone, and vecuronium induce only minimal and short-term heart rate changes, they should be considered for the anesthesia induction of patients with cardiovascular problems.