Intravenous anesthesia

Abstract

Anesthesia and Pain Medicine. 2003 Sept. 7(3): 92-99
ⓒ Korean Society for Intravenous Anesthesia
  
 
 
Changes of Blood Pressure and Heart Rate Following Endotracheal Intubation after Induction of Anesthesia with Target Controlled Infusion of Propofol and Preemptive Analgesia of Ketamine in Simple Breast Mass Excision Patients
Yong Joon Yoo, M.D., Jung Un Lee, M.D., Yong Sup Shin, M.D., Won Hyoung Lee, M.D., Soo Chang Son, M.D., and Jae Ho Choi, M.D.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
 

Background: Endotracheal intubation stimulates sympathetic and parasympathetic nervous systems. This increases catecholamine release in blood and induces hypertension and arrythmia. Target controlled infusion (TCI) of propofol achieves smooth induction of anesthesia. we compared effects of propofol administered via TCI pump on the changes of blood pressure and heart rates following endotracheal intubation. And preemptive analgesic effect of ketamine administered with propofol in surgical patients of simple breast mass.
Methods: The effect of propofol and thiopental Na on blood pressure and heart rate changes following induction of anesthesia and endotracheal intubation was investigated in a prospective, randomized trial in ASA I, II, 80 adult patients. They all had excision of simple breast mass. They were divided into four groups : Group 1 (n = 20, control); endotracheal intubation was performed after thiopental Na 4mg/kg iv administration for induction of anesthesia. Group 2 (n = 23); propofol was infused for induction of anesthesia. Group 3 (n = 17); propofol and ketamine (1 mg/kg) were infused for induction of anesthesia. Group 4 (n = 20); propofol and ketamine (1 mg/kg) were infused for induction of anesthesia. And N2O used for maintenence of anesthesia. Vecuronium was administered for endotracheal intubation in all cases. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured respectively before and after endotracheal intubation. Postoperative pain was evaluated at arrival in recovery room and 30 minute, 1 hr, 3 hr, 6 hr, 12 hr, 24 hr after operation by VAS (visual analogue scale).
Results: SBP was increased significantly (P < 0.05) after endotracheal intubation in all groups. And it was increased significantly (P < 0.05) in control group compared with other groups. DBP was increased significantly (P < 0.05) after endotracheal intubation in all groups. But there was no significant difference between groups. HR was increased significantly (P < 0.05) after endotracheal intubation in all groups. And it was increased significantly (P < 0.05) in control group compared with other groups at 1 and 3 minutes after endotracheal intubation. Postoperative VAS was decreased significantly (P < 0.05) in group 3 and 4 which ketamine was administered compared with group 2.
Conclusions: TCI of propofol decreases increasing of blood pressure and heart rate following endotracheal intubation. And continuous intravenous ketamine infusion decreases pain after breast mass excision.
 
Key words : Hemodynamic change, intubation, preemptive analgesia, propofol, target controlled infusion
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