• K Tanaka.
• Aichi Gakuin Daigaku Shigakkai Shi. 1989 Jun 1; 27 (2): 345-58.

AbstractIt is known that during anesthesia, administering medication and endotracheal intubation often cause stress for the patient which induces sthenia of the endocrinal system as well as changes in hemodynamics, sometimes leading to further systemic complications. Various changes in hemodynamics caused by endotracheal intubation in infants and children were studied, including tachycardia and increased blood pressure. Changes in catecholamine levels in blood plasma and in cardiovascular parameters were observed, with patients divided into two groups for comparison. Anesthesia of nitrous oxide-oxygen-enflurane was administered to both groups. The second group, however, received intravenous injections of lidocaine in addition to the anesthesia. The results are summarized as follows. 1) Epinephrine and norepinephrine concentrations in the plasma rose significantly following endotracheal intubation, then diminished. 2) Dopamine concentrations in the plasma reached maximum levels in 1-3 minutes following intubation, then gradually diminished. 3) Following administration of nitrous oxide-oxygen-enflurane, increases in RPP were suppressed both immediately following intubation and one minute after intubation. From this study, it is clear that stimulation caused by endotracheal intubation in infants and children triggers instant sthenia in the functions of the sympathetic nervous-medulla glandulae suprarenalic systems. The results also indicate that systemic complications during the induction of general anesthesia may be due to an increased secretion of endogenous catecholamines. These results further suggest that an intravenous injection of lidocaine is not effective in suppressing the increase of catecholamines in the plasma during endotracheal intubation. The intravenous injection of lidocaine, however, inhibits tachycardia and also inhibits the increase in blood pressure often caused by endotracheal intubation, and also serves to reduce the general oxygen demand in the cardiac tissue.

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