Masoud Lahsaee, Hamid Kamalipour, Zahra Ajeli, Karmella Kamali.
A comparison of hemodynamic changes during laryngoscopy and endotracheal intubation by using three modalities of anesthesia induction.
Anesth Pain Intens Care Jan ;16(3):247-51.

Background: Laryngoscopy and endotracheal intubation is usually associated with hemodynamic changes increases in blood pressure and heart rate. We aimed to compare the hemodynamic effects of combined use of low dose thiopentone and propofol during induction of anesthesia with conventional dose of thiopentone and propofol separately. Methodology: This trial was conducted prospectively among 90 candidates, American Society of Anaesthesiologists grade-l (ASA-I), scheduled for elective surgery, with an age range of 20-50 years. Selected patients were randomly assigned to three equal groups. Thiopentone was used in group 1, propofol in group 2, and a combination of low dose thiopentone and propofol in group 3 as an induction agent. Heart rate and blood pressures were measured non-invasively at five different times: prior to the injection of study drugs, three minutes after the last injection of induction drug and immediately before the laryngoscopy and endotracheal intubation, as well as at the first, third and fifth minutes after endotracheal intubation. Results: The adjusted mean values of systolic blood pressure, diastolic blood pressure, and heart rate were assessed by paired comparisons, by considering the variable of time; all changes were significantly different between Groups 1 and 2. Moreover, changes in systolic and diastolic blood pressures were significantly different between Groups 1 and 3. They were not significant for heart rate. No significant difference was documented between Groups 2 and 3; showing that in these groups the hemodynamic changes were small during drug injection, laryngoscopy, and intubation as well as until five minutes after endotracheal intubation. Conclusion: The combined use of low dose thiopentone and propofol for anesthetic induction caused less hemodynamic changes than the higher dose of either alone. This modality of anesthesia induction may have clinical importance for the elderly patients as well as those with high blood pressure and heart diseases.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com