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9 - Comparison of different rapid sequence anesthesia induction methods in hypertension patients
Serdar Demirgan, Emine Tozan Özyuvacı, Tolga Totoz, Başak Kutluyurdu, Ferhat Çolak, Ebru Burcu Demirgan, Emin Köse
Objective: In this study, we aimed to compare the impacts of application of three different drugs during rapid sequence anesthesia induction in hypertensive patients on responses to laryngoscopy and intubation.
Method: The study was planned as a randomized prospective study. 90 patients aged between 18-79 years old from the American society of anesthesiologists (ASA) II-III group with hypertension were included in this study. Patients were randomly divided into 3 groups of 30 people. After 3 minutes of pre-oxygenation, the patients in Group R received 1µg/ kg remifenatnil+5 mg/kg sodium thiopental, the patients in Group L received 1 mg/kg lidocaine+5mg/kg sodium thiopental, and the patients in Group F received 2µg/kg fentanil+5 mg/kg sodium thiopental through induction. As myorelaxant, 1 mg/kg rocuronium bromide was injected and intubation was performed after 60 seconds. All patients underwent intubation scoring. Hemodynamic parameters of the patients were recorded before induction, during intubation and on the 1st, 3rd, 5th and 10th minutes after intubation.
Results: There was no significant difference between the groups in terms of demographic data and intubation scoring. Systolic arterial pressures 1st, 3rd and 5th minutes after intubation found significantly higher in Group L compared to Group F and Group R. Diastolic and mean arterial pressures after intubation of 1st and 3rd minutes were found to be highest in Group L. In Group R systolic, diastolic and mean arterial pressures up to 10 minutes after intubation were detected under basal values. The heart pulse rates in the 1st and 3rd minutes after intubation were the highest in Group L and the lowest in Group R.
Conclusion: Remifentanil seems to be a better choice than lidocaine and fentanyl to reduce hemodynamic response in patients and to ensure hemodynamic stabilization during prompt anesthesia induction in hypertension patients.
Keywords: Rapid sequence anesthesia induction, intubation, hypertension, hemodynamic response
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