Attenuation of cardiovascular responses to laryngoscopy and tracheal intubation--intravenous sufentanil vs pethidine.

BACKGROUND: The study was undertaken to compare the effects of small doses of sufentanil or pethidine on cardiovascular responses induced by tracheal intubation.

METHODS: Sixty ASA physical status I-II patients, scheduled for elective abdominal surgery under general anesthesia, were randomly allocated in a double blind fashion to receive an intravenous bolus of either sufentanil 0.1 microg/kg (Group S, n = 30) or pethidine 1.5 mg/kg (Group P, n = 30) for induction of anesthesia. The heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were measured before induction of anesthesia (baseline), at 1-min intervals for 3 min after the induction of anesthesia, and at 1, 3, 5, and 7 min after start of laryngoscopy.

RESULTS: No significant differences in SAP, DAP, and MAP were observed between the two groups. Heart rate was significantly increased 2 and 3 minutes after induction of anesthesia and 1 minute after intubation in group P as compared to group S (P < 0.01). However, the numbers of patients who developed a heart rate increase more than 20% of basal value were not different between two groups. At the end of the study period, systolic, diastolic, and mean arterial pressure slightly decreased from preinduction values was transient and did not require treatment.

CONCLUSIONS: If adequate timing in opioid administration is warranted according to the time to peak effect of each opioid drug, small doses of sufentanil or pethidine could provide effective control of the inotropic response induced by laryngoscopy and tracheal intubation.