Effect Of Diltiazem On Cardiovascular Response To Tracheal Intubation

Objective Tracheal intubation can induce haemodynamic response, such as hypertension,tachycardia and arrhythmias. Such cardiovascular disturbances may be dangerous in some patients, particularly those who suffer from coronary heart disease .We compare MAP, HR, RPP and DCG changes between contrl-group and diltiazem-group to evaluate the effect of diltiazem on cardiovascular responses to tracheal intubation. Methods Fifty-two coronary heart disease (CHD) patients aged 41 - 86yr, weighting 55 - 90kg, scheduled for coronary artery bypass grafting (CABG) under general anesthesia were randomly divided into 2 grougs: diltiazem-group(n=24) and control-group(n=28). Premedication consisted of intramuscular scopolamine 0.3mg and morphine 10mg. In diltiazem-group diltiazem 0.2mg/kg was injected slowly within 2 minutes before induction while in control-group saline 5ml was given instead. Anesthesia was induced with midazolam 0.02-0.04mg/kg, fentanyl 4ug/kg, etomidate 0.2-0.3mg/kg. Intubation was facilitated with rocuronium 0.6— 0.8mg/kg. Laryngoscopy and tracheal intubation was successfully performed within 30 seconds. SBP, DBP, MAP and HR were recorded at designed time points. Dynamic Electrocardiogram ( DCG )was continuously monitored from 10 minutes before intubation to 15 minutes after intubation. Results Patients who received saline showed a significant increase in SBP, DBP, MAP and HR and rate pressure product (RPP) associated with tracheal intubation. These increases after tracheal intubation were reduced in diltiazem-treated patients compared with those of the control-group except of significant increase in HR at 1minute after...