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Paper Information

Journal:   TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)   APRIL 2008 , Volume 66 , Number 1; Page(s) 18 To 24.
 
Paper: 

HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION: PROPOFOL VERSUS THIOPENTAL SODIUM

 
 
Author(s):  NOUYAN ASHRAF M.A., AKHGAR ARAGHI A.*, PEYRAVI SERESHKEH H., AKHGAR F.
 
* DEPT. OF ANESTHESIA, ALLIED MEDICAL SCHOOL, KESHAVARZ BLVD., TEHRAN, IRAN
 
Abstract: 

Background: The induction of anesthesia, laryngoscopy and endotracheal intubation can be associated with hemodynamic responses such as tachycardia, bradycardia, hypertension, hypotension and so forth. Changes in arterial pressure (>25%) can be associated with cardiovascular complications and impairment of cerebral perfusion. The aim of this study was to evaluate hemodynamic responses to laryngoscopy and intubation after propofol versus thiopental anesthesia.
Methods: One hundred and eighty ASA class I patients, aged 20-50 years, were enrolled in a randomized clinical trial (RCT), divided into propofol and thiopental groups and evaluated for hemodynamic response to induction of anesthesia and to laryngoscopy/ intubation. Data collection parameters included systolic pressure (sp), diastolic pressure (dp), mean arterial pressure (map) and heart rate. Analysis was performed using SPSS version 13.5, t-test and
c2 test to determine the significance of the results.
Results: From a total of 180 patients, 91 (50.6%) were male and 89 (49.4) were female. There were no differences in age, weight or gender between the two study groups (p>0.05). Changes in the hemodynamic indices on the operation table from before induction to those after premedication had no significant difference. There were no significant differences in the decrease of sp/dp ratio or map between the two groups. Mean changes in heart rate were 11.5 ±5.43 and 5.37 ±3.5/min in the thiopental versus the propofol group, respectively. The only significant difference between the two groups was the increase in heart rate after intubation for the thiopental group.
Conclusion: The only difference in the hemodynamic indices of normal healthy patients after induction of anesthesia or those after intubation while using propofol versus thiopental Na was in the tachycardia reflex to laryngoscopy and intubation, which was less after propofol induction. For this reason, propofol may be the better choice for anesthesia induction, especially for coronary patients.

 
Keyword(s): ANESTHESIA, HEMODYNAMIC, LARYNGOSCOPY, INTUBATION, PROPOFOL, THIOPENTAL
 
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