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      KCI등재 SCOPUS SCIE

      전신마취 유도 시 Esmolol과 Remifentanil이 기관내 삽관에 의한 심혈관 반응과 카테콜아민에 미치는 영향 = Comparing the effects of esmolol and remifentanil on the cardiovascular and catecholamine response to endotracheal intubation during the induction of general anesthesia

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      https://www.riss.kr/link?id=A104350121

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      다국어 초록 (Multilingual Abstract)

      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation.
      Methods: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation.
      Results: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P < 0.05). The heart rate after endotracheal intubation was lower in the remifentanil group than that in the esmolol group. No significant differences of the catecholamine responses to endotracheal intubation were observed among the three groups (P > 0.05).
      Conclusions: 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.
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      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the eff...

      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation.
      Methods: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation.
      Results: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P < 0.05). The heart rate after endotracheal intubation was lower in the remifentanil group than that in the esmolol group. No significant differences of the catecholamine responses to endotracheal intubation were observed among the three groups (P > 0.05).
      Conclusions: 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.

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      다국어 초록 (Multilingual Abstract)

      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation.
      Methods: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation.
      Results: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P < 0.05). The heart rate after endotracheal intubation was lower in the remifentanil group than that in the esmolol group. No significant differences of the catecholamine responses to endotracheal intubation were observed among the three groups (P > 0.05).
      Conclusions: 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.
      번역하기

      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the eff...

      Background: Esmolol and remifentanil are widely used drugs that minimize the increase of the blood pressure and the heart rate in response to endotracheal intubation during the induction of anesthesia. The purpose of this study is to compare the effect of esmolol and remifentanil on the cardiovascular and catecholamine responses to endotracheal intubation.
      Methods: Sixty ASA I and II patients were randomly allocated to three groups. Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.9 mg/kg and this was maintained with 2 vol% sevoflurane and 50% nitrous oxide in oxygen. The patients received 10 ml intravenous saline (control group), 1.5 mg/kg esmolol (esmolol group) or 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min (remifentanil group) before intubation. The noninvasive blood pressure and heart rate were recorded before induction (baseline), before intubation and at 1, 2, 3 and 5 minutes after intubation. The blood catecholamine level (epinephrine and norepinephrine) was measured before induction and at 1 and 5 minutes after intubation.
      Results: The systolic, diastolic and mean arterial pressures after endotracheal intubation were similar in the control and esmolol groups, but they were lower in the remifentanil group (P < 0.05). The heart rate after endotracheal intubation was lower in the remifentanil group than that in the esmolol group. No significant differences of the catecholamine responses to endotracheal intubation were observed among the three groups (P > 0.05).
      Conclusions: 1μg/kg remifentanil followed by an infusion of 0.1μg/kg/min is more effective than 1.5 mg/kg esmolol for inhibiting the cardiovascular responses following endotrachal intubation during the induction of general anesthesia.

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      참고문헌 (Reference)

      1 Helfman SM, "Which drug prevents tachycardia and hypertension associated with tracheal intubation: lidocaine, fentanyl, or esmolol?" 72 : 482-486, 1991

      2 Thomson IR, "The haemodynamic response to intubation: a perspective" 36 : 367-369, 1989

      3 Stevens JB, "The haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia" 41 : 502-505, 1997

      4 Hussain AM, "Sultan ST : Efficacy of fentanyl and esmolol in the prevention of haemodynamic response to laryngoscopy and endotracheal intubation" 15 : 454-457, 2005

      5 Kahl M, "Stress response to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway" 18 : 275-280, 2004

      6 Derbyshire DR, "Smith G : Plasma catecholamine responses to tracheal intubation" 55 : 855-860, 1983

      7 Rosow C, "Remifentanil: a unique opioid analgesic" 79 : 875-876, 1993

      8 Choi BI, "Remifentanil prevents withdrawal movements caused by intravenous injection of rocuronium" 30 : 211-216, 2008

      9 Glass PS, "Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil" 77 : 1031-1040, 1993

      10 Gorczynski RJ, "Pharmacology of ASL 8052, a novel beta adrenergic receptor antagonist with an ultrashort duration of action" 5 : 668-677, 1983

      1 Helfman SM, "Which drug prevents tachycardia and hypertension associated with tracheal intubation: lidocaine, fentanyl, or esmolol?" 72 : 482-486, 1991

      2 Thomson IR, "The haemodynamic response to intubation: a perspective" 36 : 367-369, 1989

      3 Stevens JB, "The haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia" 41 : 502-505, 1997

      4 Hussain AM, "Sultan ST : Efficacy of fentanyl and esmolol in the prevention of haemodynamic response to laryngoscopy and endotracheal intubation" 15 : 454-457, 2005

      5 Kahl M, "Stress response to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway" 18 : 275-280, 2004

      6 Derbyshire DR, "Smith G : Plasma catecholamine responses to tracheal intubation" 55 : 855-860, 1983

      7 Rosow C, "Remifentanil: a unique opioid analgesic" 79 : 875-876, 1993

      8 Choi BI, "Remifentanil prevents withdrawal movements caused by intravenous injection of rocuronium" 30 : 211-216, 2008

      9 Glass PS, "Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil" 77 : 1031-1040, 1993

      10 Gorczynski RJ, "Pharmacology of ASL 8052, a novel beta adrenergic receptor antagonist with an ultrashort duration of action" 5 : 668-677, 1983

      11 Edwards ND, "Myocardial ischemia during tracheal intubation and extubation" 73 : 537-539, 1994

      12 Coley S, "Haemodynamic changes after induction of anaesthesia and tracheal intubation following propofol or thiopentone in patients of ASA grade I and III" 63 : 423-428, 1989

      13 Lindgren L, "Haemodynamic and catecholamine responses to induction of anaesthesia and tracheal intubation: comparison between propofol and thiopentone" 70 : 306-310, 1993

      14 McAtamney D, "Evaluation of remifentanil for control of haemodynamic response to tracheal intubation" 53 : 1223-1227, 1998

      15 Gaubatz CL, "Evaluation of esmolol and fentanyl in controlling increases in heart rate and blood pressure during endotracheal intubation" 59 : 91-96, 1991

      16 Moffitt EA, "Effects of intubation on coronary blood flow and myocardial oxygenation" 32 : 105-111, 1985

      17 Ugur B, "Effects of esmolol, lidocaine and fentanyl on haemodynamic responses to endotracheal intubation: a comparative study" 27 : 269-277, 2007

      18 Thompson JP, "Effect of remifentanil on the haemodynamic response to orotracheal intubation" 80 : 467-469, 1998

      19 Slogoff S, "Does perioperative myocardial ischemia lead to postoperative myocardial infarction?" 62 : 107-114, 1985

      20 Liu PL, "Covino BG: Esmolol for control of increases in heart rate and blood pressure during tracheal intubation after thiopentone and succinylcholine" 33 : 556-562, 1986

      21 Bruder N, "Consequences and prevention methods of hemodynamic changes during laryngoscopy and intratracheal intubation" 11 : 57-71, 1992

      22 Fox EJ, "Complications related to the pressor response to endotracheal intubation" 47 : 524-525, 1977

      23 Misiolek H, "Comparison of influence of thiopentone, propofol and midazolam on blood serum concentration of noradrenaline and cortisol in patients undergoing non-toxic struma operation" 6 : 319-324, 2000

      24 Russell WJ, "Changes in plasma catecholamine concentrations during endotracheal intubation" 53 : 837-839, 1981

      25 Chraemmer-Jorgensen B, "Catecholamine response to laryngosocpy and intubation. The influence of three different drug combinations commonly used for induction of anaesthesia" 47 : 750-756, 1992

      26 Wierda JM, "Cardiovascular effects of an intubating dose of rocuronium 0.6 mg kg-1 in anaesthetized patients, paralysed with vecuronium" 78 : 586-587, 1997

      27 Menkhaus PG, "Cardiovascular effect of esmolol in anesthetized humans" 64 : 327-324, 1985

      28 Ebert TJ, "Attenuation of hemodynamic responses to rapid sequence induction and intubation in healthy patients with a single bolus of esmolol" 2 : 243-252, 1990

      29 Forbes AM, "Acute hypertension during induction of anaesthesia and endotracheal intubation in normotensive man" 42 : 618-624, 1970

      30 Parnass SM, "A single bolus dose of esmolol in the prevention of intubation-induced tachycardia and hypertension in an ambulatory surgery unit" 2 : 232-237, 1990

      31 Glass PS, "A review of the pharmacokinetics and pharmacodynamics of remifentanil" 89 (89): S7-S14, 1999

      32 Sheppard S, "A bolus doses of esmolol attenuates tachycardia and hypertension after treacheal intubation" 37 : 202-205, 1990

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