The Effect of Labetalol or Remifentanil on Blood Pressure and Heart Rate after Laryngoscopy and Intubation

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The main aim of this study was to compare the effect of labetalol and remifentanil on blood pressure and heart rate after laryngoscopy and intubation in comparison with the control group.Methods: In a clinical trial study, 105 patients scheduled for surgery were randomly assigned to three groups receiving 1 mg/kg of labetalol, 1 µg/kg remifentanil, or the same amount of normal saline. Hemodynamic parameters were measured and compared.Findings: The incidence of bradycardia in groups receiving labetalol, remifentanil and control was 28.6%, 22.9% and 5.7%, respectively, and the difference between three groups was significant (P = 0.040). In contrast, the incidence of tachycardia in the three groups was 2.9%, 5.7% and 28.6%, respectively, and significant difference was observed between the groups (P = 0.002). The prevalence of hypotension in the three groups was 22.9%, 14.3% and 2.9%, respectively, and there were significant differences among them (P = 0.047). The prevalence of hypertension in the three groups was 6.3%, 18.8% and 34.3%, respectively, and the difference between the groups was significant (P = 0.001).Conclusion: Based on the results of the present study, intravenous administration of 1 mg/kg labetalol in patients under laryngoscopy tends to more favorable hemodynamic stability and less hemodynamic imparements compared to remifentanil; using this dose before the laryngoscopy is more favorable.

Keywords

References

  1. Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59(3): 295-9.
  2. Edwards ND, Alford AM, Dobson PM, Peacock JE, Reilly CS. Myocardial ischaemia during tracheal intubation and extubation. Br J Anaesth 1994; 73(4): 537-9.
  3. Roy WL, Edelist G, Gilbert B. Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease. Anesthesiology 1979; 51(5): 393-7.
  4. Singh SP, Quadir A, Malhotra P. Comparison of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation. Saudi J Anaesth 2010; 4(3): 163-8.
  5. Chung KS, Sinatra RS, Chung JH. The effect of an intermediate dose of labetalol on heart rate and blood pressure responses to laryngoscopy and intubation. J Clin Anesth 1992; 4(1): 11-5.
  6. Inada E, Cullen DJ, Nemeskal AR, Teplick R. Effect of labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study. J Clin Anesth 1989; 1(3): 207-13.
  7. Leslie JB, Kalayjian RW, McLoughlin TM, Plachetka JR. Attenuation of the hemodynamic responses to endotracheal intubation with preinduction intravenous labetalol. J Clin Anesth 1989; 1(3): 194-200.
  8. Glass PS, Hardman D, Kamiyama Y, Quill TJ, Marton G, Donn KH, et al. Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil (GI87084B). Anesth Analg 1993; 77(5): 1031-40.
  9. Lee JH, Kim H, Kim HT, Kim MH, Cho K, Lim SH, et al. Comparison of dexmedetomidine and remifentanil for attenuation of hemodynamic responses to laryngoscopy and tracheal intubation. Korean J Anesthesiol 2012; 63(2): 124-9.
  10. Dietrich WD, Alonso O, Busto R. Moderate hyperglycemia worsens acute blood-brain barrier injury after forebrain ischemia in rats. Stroke 1993; 24(1): 111-6.
  11. Goldberg ME, McNulty S, Levette A, Goldman S. Intravenous labetalol for induced hypotension in an adult patient undergoing coarctation repair. J Cardiothorac Anesth 1988; 2(5): 673-7.
Journal of Isfahan Medical School
Volume 34, Issue 408 - Serial Number 408
September and October 2017
Pages 1395-1400

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History

  • Receive Date: 24 September 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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