• M Igarashi, K Nishikawa, M Nakayama, K Sato, A Kita, K Tsunoda, H Tsuchida, and A Namiki.
• Department of Anesthesia, Nikko Memorial Hospital, Muroran.
• Masui. 1998 Oct 1;47(10):1193-9.

AbstractWe examined the circulatory changes after intravenous thiamylal with additional injection of thiamylal 1 minute before intubation and after propofol at the time of anesthetic induction and endotracheal intubation. Sixty ASA I or II patients were studied after the institutional and informed consents. We compared the following three groups. Group I (n = 20): Anesthesia was induced with thiamylal 5 mg.kg-1 and intubation with the aid of vecuronium 0.1 mg.kg-1. Group II (n = 20): Anesthesia was induced with thiamylal 3 mg.kg-1 and vecuronium 0.1 mg.kg-1. One minute before the intubation, the patients received additional thiamylal 4 mg.kg-1. Group III (n = 20): Anesthesia was induced with propofol 2.5 mg.kg-1 and intubation was performed with the aid of vecuronium 0.1 mg.kg-1. We examined the systolic, diastolic and mean blood pressures, heart rate, and rate pressure product (RPP) in the three groups. The examinations were performed before and after induction, soon after intubation, and every one minute after intubation for 5 minutes. After the endotracheal intubation, the systolic blood pressure and heart rate increased in Group I. But the systolic and diastolic pressures were significantly more stable in Group II and Group III. The change of the RPP was slight and most stable in Group II compared with the other two groups. We conclude that additional injection of thiamylal 4 mg.kg-1 following induction of anesthesia with thyamylal 3 mg.kg-1 1 minute before endotracheal intubation is an effective method for minimizing the increase in blood pressure and circulatory changes at the time of rapid induction of anesthesia and endotracheal intubation.

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