The Effects of Intravenous Nitroglycerin Bolus Doses in Reducing Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation

Background. Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining th...

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Published in:BioMed research international 2021, Vol.2021 (1), p.0-6694150
Main Authors: Hajian, Pouran, Sharifi, Shabnaz, Nikooseresht, Mahshid, Moradi, Abbas
Format: Article
Language:English
Subjects:
Analysis
Anesthesia
Blood pressure
Cardiovascular diseases
Cerebrovascular diseases
Clinical trials
Complications
Coronary artery disease
Data collection
Dosage and administration
Drug delivery systems
Drug dosages
Elective surgery
Fentanyl
Heart diseases
Heart rate
Hemodynamic responses
Hemodynamics
Hypertension
Intravenous administration
Intubation
Ischemia
Laryngoscopy
Medical instruments
Nitroglycerin
Patient outcomes
Patients
Placebos
Testing
Trachea
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description Background. Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation (P>0.05). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group (P
doi_str_mv 10.1155/2021/6694150
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Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation (P&gt;0.05). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group (P&lt;0.05). However, no significant difference was observed between the intervention groups. The frequency of systolic blood pressure decrease was significantly different in the first and fifth minutes after intubation in the three study groups (P&lt;0.05). Conclusion. Bolus doses of 1 and 2 μg/kg nitroglycerin in noncardiac elective surgery prevents the increase of mean systolic, diastolic, and arterial blood pressure but has no significant effect on heart rate after intubation.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2021/6694150</identifier><identifier>PMID: 34395624</identifier><language>eng</language><publisher>New York: Hindawi</publisher><subject>Analysis ; Anesthesia ; Blood pressure ; Cardiovascular diseases ; Cerebrovascular diseases ; Clinical trials ; Complications ; Coronary artery disease ; Data collection ; Dosage and administration ; Drug delivery systems ; Drug dosages ; Elective surgery ; Fentanyl ; Heart diseases ; Heart rate ; Hemodynamic responses ; Hemodynamics ; Hypertension ; Intravenous administration ; Intubation ; Ischemia ; Laryngoscopy ; Medical instruments ; Nitroglycerin ; Patient outcomes ; Patients ; Placebos ; Testing ; Trachea</subject><ispartof>BioMed research international, 2021, Vol.2021 (1), p.0-6694150</ispartof><rights>Copyright © 2021 Pouran Hajian et al.</rights><rights>COPYRIGHT 2021 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2021 Pouran Hajian et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation (P&gt;0.05). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group (P&lt;0.05). However, no significant difference was observed between the intervention groups. The frequency of systolic blood pressure decrease was significantly different in the first and fifth minutes after intubation in the three study groups (P&lt;0.05). Conclusion. Bolus doses of 1 and 2 μg/kg nitroglycerin in noncardiac elective surgery prevents the increase of mean systolic, diastolic, and arterial blood pressure but has no significant effect on heart rate after intubation.</description><subject>Analysis</subject><subject>Anesthesia</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Cerebrovascular diseases</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Coronary artery disease</subject><subject>Data collection</subject><subject>Dosage and administration</subject><subject>Drug delivery systems</subject><subject>Drug dosages</subject><subject>Elective surgery</subject><subject>Fentanyl</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Hemodynamic responses</subject><subject>Hemodynamics</subject><subject>Hypertension</subject><subject>Intravenous administration</subject><subject>Intubation</subject><subject>Ischemia</subject><subject>Laryngoscopy</subject><subject>Medical instruments</subject><subject>Nitroglycerin</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Placebos</subject><subject>Testing</subject><subject>Trachea</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp9kk9r3DAQxU1paUKaWz-AoJdCu41G_2xfCkm6bQJLCiU9C1keexVsaWvZKXvtJ6-8uyQkh-giafTjad5jsuw90C8AUp4xyuBMqVKApK-yY8ZBLBQIeP1w5vwoO43xjqZVgKKlepsdccFLqZg4zv7drpEsmwbtGEloyLUfB3OPPkyR3LhxCG23tTg4Ty5Cl2rfQsRI0vUX1pN1viVX2Id6603vbCrGTfAzMQayMsPWtyHasNkS42uy9HVI6naNpps_miozuuDfZW8a00U8Pewn2e_vy9vLq8Xq54_ry_PVwooCxgVwyHNmSs7yirKCGV4JxFyKBqsShCoKIZUVhu0oCU3NVJ4AI0SOlnJ-kn3d626mqsfa4my105vB9alTHYzTT1-8W-s23OuCS5niSgIfDwJD-DNhHHXvosWuMx5TXppJBSWjlBcJ_fAMvQvT4JO9HcVZAbJ8pFrToXa-2cUzi-pzVaoiVwD8ZSr1loNgLFGf95QdQowDNg_GgOp5VvQ8K_owKwn_tMfXztfmr3uZ_g-ga7tP</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Hajian, Pouran</creator><creator>Sharifi, Shabnaz</creator><creator>Nikooseresht, Mahshid</creator><creator>Moradi, Abbas</creator><general>Hindawi</general><general>John Wiley &amp; 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Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation (P&gt;0.05). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group (P&lt;0.05). However, no significant difference was observed between the intervention groups. The frequency of systolic blood pressure decrease was significantly different in the first and fifth minutes after intubation in the three study groups (P&lt;0.05). Conclusion. Bolus doses of 1 and 2 μg/kg nitroglycerin in noncardiac elective surgery prevents the increase of mean systolic, diastolic, and arterial blood pressure but has no significant effect on heart rate after intubation.</abstract><cop>New York</cop><pub>Hindawi</pub><pmid>34395624</pmid><doi>10.1155/2021/6694150</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-4482-6587</orcidid><orcidid>https://orcid.org/0000-0003-4994-0936</orcidid><orcidid>https://orcid.org/0000-0002-3086-717X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Analysis
Anesthesia
Blood pressure
Cardiovascular diseases
Cerebrovascular diseases
Clinical trials
Complications
Coronary artery disease
Data collection
Dosage and administration
Drug delivery systems
Drug dosages
Elective surgery
Fentanyl
Heart diseases
Heart rate
Hemodynamic responses
Hemodynamics
Hypertension
Intravenous administration
Intubation
Ischemia
Laryngoscopy
Medical instruments
Nitroglycerin
Patient outcomes
Patients
Placebos
Testing
Trachea
title The Effects of Intravenous Nitroglycerin Bolus Doses in Reducing Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation
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