Effects of trimetaphan on the cardiovascular response to tracheal intubation

In three groups of 10 patients, we have studied the effect on the cardiovascular responses to laryngoscopy and intubation of bolus doses of saline or trimetaphan 0.05 mg kg-1 or 0.1 mg kg-1 given 1.75 min before the start of laryngoscopy. Anaesthesia was induced with thiopentone 5 mg kg-1 i.v. and tracheal intubation was facilitated with vecuronium 0.2 mg kg-1. During anaesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Patients receiving saline showed a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. These increases following tracheal intubation were less in trimetaphan-treated patients compared with those of the control group (P less than 0.05). There was no significant difference in heart rate following tracheal intubation between the three groups. These data suggest that trimetaphan may be used as a supplement during induction, to attenuate the hypertensive response associated with laryngoscopy and tracheal intubation.