• N Maekawa, K Mikawa, M Hasegawa, H Kaetsu, R Goto, H Yaku, Y Takao, K Nishina, and H Obara.
• Department of Anesthesiology, Kobe University School of Medicine, Japan.
• J Clin Anesth. 1992 Jul 1; 4 (4): 297-300.

Study ObjectiveTo evaluate the efficacy and safety of nisoldipine given orally in attenuating the cardiovascular responses to laryngoscopy and tracheal intubation.DesignRandomized, double-blind, placebo-controlled study.SettingInduction of anesthesia for elective surgery at a university hospital.PatientsThirty normotensive patients (ASA physical status I) undergoing elective surgery were assigned to one of three groups; placebo, nisoldipine 5 mg, or nisoldipine 10 mg. Each group consisted of ten patients.InterventionsEither 5 mg of nisoldipine, 10 mg of nisoldipine, or a placebo was administered orally 2 hours before induction of anesthesia. Anesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Laryngoscopy lasting 30 seconds was attempted 2 minutes after administration of thiopental sodium and vecuronium.Measurements And Main ResultsPatients receiving the placebo showed a significant increase in mean arterial pressure associated with tracheal intubation. These increases following tracheal intubation were significantly reduced in patients receiving nisoldipine 10 mg compared with patients receiving the placebo (p less than 0.05).ConclusionsOral administration of nisoldipine before induction of anesthesia is a simple, practical, and safe method for attenuating pressor response to laryngoscopy and tracheal intubation.

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