Abstract
Forty patients ASA physical status I-III were selected and divided into four groups. Group I, Control, received saline pretreatment five minutes prior to rapid sequence induction and intubation, while Groups II, III and IV received propranolol 0.01 mg.kg-1 IV two, five or eight minutes prior to induction and intubation. Measurements of heart rale (HR), arterial blood pressure (ABP) were recorded as baseline values and at one, two, five, eight and 20 minutes, and simultaneous venous samples were withdrawn for propranolol levels. Calculated rate pressure product (RPP) showed best haemodynamic control in Group III. Serum propranolol levels were under 5 ng.ml-1 in Group III and undetectable in Group IV. Our data show that the optimal time interval between IV propranolol administration and intubation was five minutes.
Résumé
Quarante patients classés ASA I à III ont été choisis et répartis en quatre groupes. Le groupe I (groupe contrôle) a reçu un prétraitement de soluté salin cinq minutes avant l’induction et l’intubation en séquence rapide, alors que les groupes II, III et IV ont reçu du propranolol 0.01 mg.kg-1 intraveineux deux, cinq et huit minutes avant l’induction et l’intubation. Les mesures de la fréquence cardiaque (HR) et de la pression artérielle (ABP) ont été enregistrées à la période contrôle et, ensuite, à une, deux, cinq, huit et vingt minutes; au même temps, des échantillons de sang étaient prélevés pour déterminer les niveaux plasmatiques de propranolol. Les produits fréquence-pression (RPP) se sont montrés plus stables dans le groupe III. Les niveaux plasmatiques de propranolol étaient inférieurs à 5 ng-ml-1 dans le groupe III et non décelables dans le groupe IV. Ces données montrent qu’un intervalle de cinq minutes entre l’administration du propranolol intraveineux et l’intubation est souhaitable.
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References
Safwat AM, Reitan JA, Misle GR, Hurley EJ. Use of propranolol to control rate-pressure product during cardiac anesthesia. Anesth Analg 1981: 60:732–5.
Shand DG, Nucholls EM, Oates JA. Plasma propranolol levels in adults with observations in four children. Clin Pharmacol Ther 1970; 11:112–20.
Prys-Roberts C. Foex P, Biro GP, Roberts JG. Studies of anaesthesia in relation to hypertension. V. Adrenergic beta-receptor blockade. Br J Anaesth 1973; 45:671–81.
Prys-Roberts C, Meloche R. Management of anaesthesia in patients with hypertension or ischemic heart disease. Int Anesthesiol Clin 1980; 18:181–217.
Coleman AJ, Jordan C. Cardiovascular responses to anaesthesia: Influence of beta-adrenoreceptor blockade with metoprolol. Anaesthesia 1980; 35:972.
Sonntag H, Laser R. Myocardial blood flow and oxygen consumption during high-dose fentanyl anesthesia in patients with coronary artery disease. Anesthesiology 1982; 56:417–22.
Coitart DJ, Shand DG. Plasma propranolol levels in the quantitative assessment of B-adrenergic blockade in man. Br Med J 1970; 3:731–4.
Lochan R, Silke B, Taylor SH. Speed of onset of pharmacodynamic activity of propranolol, practolol, oxprenolol and metoprolol after intravenous injection in man. Br J Clin Pharmacol 1981; 12:721–4.
Romagnoli A, Keats AS. Plasma and atrial propranolol after preoperative withdrawal. Circulation 1975; 52:1123–7.
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Safwat, A.M., Fung, D.L. & Bilton, D.C. The use of propranolol in rapid sequence anaesthetic induction: optimal time interval for pretreatment. Can Anaesth Soc J 31, 638–641 (1984). https://doi.org/10.1007/BF03008759
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DOI: https://doi.org/10.1007/BF03008759