HAEMODYNAMIC AND CATECHOLAMINE RESPONSES TO INDUCTION OF ANAESTHESIA AND TRACHEAL INTUBATION: COMPARISON BETWEEN PROPOFOL AND THIOPENTONE

• Published in: British journal of anaesthesia : BJA 1993-03, Vol.70 (3), p.306-310
• Main Authors: LINDGREN, L., YLI-HANKALA, A., RANDELL, T., KIRVELÄ, M., SCHEININ, M., NEUVONEN, P.J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anaesthetics; Anaesthetics, intravenous: propofol, thiopentone; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Blood Pressure - drug effects; Electrocardiography - drug effects; Epinephrine - blood; Female; Heart Rate - drug effects; Hemodynamics - physiology; Humans; intravenous: propofol; Intubation; Intubation, Intratracheal; Intubation, tracheal: haemodynamic response; Male; Medical sciences; Neuropharmacology; Norepinephrine - blood; Pharmacology. Drug treatments; Propofol; Sympathetic nervous system: catecholamines; Thiopental; thiopentone; Time Factors; tracheal: haemodynamic response
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/70.3.306

We have studied the haemodynamic changes, QT intervals and catecholamine responses to induction of anaesthesia and tracheal intubation in 24 ASA I patients allocated randomly to receive either pro-pofol 2.5 mg kg-1 or thiopentone 5 mg kg-1 over 60 s. After disappearance of the eyelash reflex, the lungs were ventilated with 100% oxygen for 3 min. The trachea was intubated after administration of vecuronium. With thiopentone, heart rate (HR) was greater than with propofol before intubation (P < 0.05). During induction, systolic (SAP) and diastolic arterial pressure (DAP) decreased more with propofol than with thiopentone. The QT interval was prolonged only during induction with thiopentone. In both groups, HR, SAP, DAP and the QT were increased in response to intubation (P < 0.001). The SAP and QT interval responses to intubation were significantly greater with thiopentone than with propofol (P < 0.05). One patient in the thiopentone group with a significantly prolonged QT interval had episodes of bigeminy and ventricular tachycardia. In both groups, concentrations of noradrenaline in mixed venous plasma increased after intubation (P < 0.001). Concentrations of adrenaline increased after intubation only in the thiopentone group (P < 0.001). (Br. J. Anaesth. 1993; 70: 306–310)