Comparison of lidocaine and urapidil for prevention of hemodynamic response to tracheal intubation in patients in general good health
Santiveri, X.; Ledesma, M.; Delás, F.; García, C.; Vilaplana, J.; Villalonga, A.
Revista Espanola de Anestesiologia y Reanimacion 45(2): 46-49
1998
ISSN/ISBN: 0034-9356 PMID: 9567633 Document Number: 484153
To compare the efficacy of endovenous administration of 0.5 mg/kg-1 of urapidil to 1 mg/kg-1 of lidocaine for attenuating hemodynamic response to laryngoscopy and tracheal intubation. Study of 40 ASA I and II patients with normal blood pressure undergoing elective surgery under general anesthesia with orotracheal intubation. The patients were randomly assigned to two groups to receive either 0.5 mg/kg-1 of urapidil or 1 mg/kg-1 five minutes before anesthetic induction. Anesthesia was provided with 0.04 mg/kg-1 of midazolam, 2 micrograms/kg-1 of fentanyl, 2 mg/kg-1 of propofol, 0.1 mg/kg-1 of vecuronium before proceeding to orotracheal intubation, after electromyographic determination of neuromuscular response with T1 less than 5%, and laryngoscopy. Heart rate, systolic, diastolic and mean pressures, and the product of heart rate and mean arterial pressure (HR x MAP) were recorded at the following times: baseline (before administering either lidocaine or urapidil), after induction, after laryngoscopy and intubation, and 3 minutes and 5 minutes after intubation. ASA classification, age, sex and weight were similar in the two groups. Heart rate immediately after intubation, and after 3 and 5 minutes was significantly lower in the lidocaine group. Likewise HR x MAP immediately after intubation and 3 minutes later was significantly lower in the patients who received lidocaine. In healthy ASA I and II patients with normal blood pressure, a dose of 1 mg/kg-1 of lidocaine provided better protection against the hemodynamic response to laryngoscopy and tracheal intubation than does 0.5 mg/kg-1 of urapidil.