Ketanserin and the cardiovascular response to intubation: a preliminary report

Several methods of attenuating the adverse cardiovascular effects of laryngoscopy and intubation are available. The obtunding effect of ketanserin 0.5 mg kg-1 versus that of a placebo, given 5 min prior to intubation, was investigated in a randomized double-blind trial in a group of 40 patients. Blood pressure (systolic, mean and diastolic) and pulse rate were measured at 1-min intervals with an Accutor blood pressure apparatus for 5 min before and 5 min after the injection of ketanserin or placebo, as well as for 6 min after a standardized induction (thiopentone and suxamethonium), laryngoscopy and intubation. The patients who had received ketanserin had a statistically significant lower systolic blood pressure (1 and 4 min), as well as significantly lower mean and diastolic blood pressures at 1, 2, 3 and 4 min. There were no unexpected untoward side-effects. Further investigations are suggested using ketanserin as part of a multi-faceted pharmacological approach to decrease the adverse effects of laryngoscopy and intubation.