• K Mikawa, J Ikegaki, N Maekawa, H Hoshina, O Tanaka, R Goto, and H Obara.
• Department of Anesthesiology, Kobe University School of Medicine, Japan.
• J Clin Anesth. 1990 Nov 1; 2 (6): 420-4.

Study ObjectiveTo evaluate the efficacy of prostaglandin E1 in attenuating the hypertensive response to laryngoscopy and intubation.DesignControlled, comparative, and randomized study.SettingInduction of anesthesia for elective surgery at a university hospital.PatientsThirty normotensive patients (ASA physical status I) undergoing elective surgery divided into three groups. Each group consisted of ten patients.InterventionsAnesthesia was induced with thiopental sodium 5 mg/kg intravenously, and tracheal intubation was facilitated with vecuronium 0.2 mg/kg. Either 0.3 micrograms/kg of prostaglandin E1, 0.6 micrograms/kg of prostaglandin E1, or saline (control) was injected 15 seconds before starting direct laryngoscopy (within 30 seconds), which was attempted 2 minutes after administration of thiopental sodium and vecuronium.Measurements And Main ResultsPatients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increases following tracheal intubation were significantly less in prostaglandin E1-treated patients than in the control group (p less than 0.05).ConclusionsA single rapid intravenous administration of prostaglandin E1 is a practical pharmacologic and safe method to attenuate the hypertensive response to tracheal intubation. The use of 0.6 micrograms/kg of prostaglandin E1 as a supplement during induction is recommended for reducing the pressor response to intubation on the basis of rate-pressure product and mean arterial pressure following intubation as an index.

22 keywords...

hide…