[Comparison of 4 anesthesia induction protocols on hemodynamic changes in tracheal intubation]

This study was undertaken to determine whether alfentanil (A) or sufentanil (S) associated with propofol (P) or etomidate (E) can abolish or attenuate the hemodynamic response to laryngoscopy and orotracheal intubation in ASA I or II patients, during induction of anesthesia for lumbar spinal surgery. Eighty patients were randomly divided into four groups. Group I (AE) received alfentanil 30 micrograms/kg and etomidate 0.3 mg/kg; group II (AP) received alfentanil 30 micrograms/kg and propofol 1.5 mg/kg; group III (SE) received sufentanil 0.3 microgram/kg and etomidate 0.3 mg/kg; group IV (SP) received sufentanil 0.3 microgram/kg and propofol 1.5 mg/kg. In each group, narcotic and hypnotic were given respectively five minutes and three minutes before laryngoscopy. The intubation was facilitated by vecuronium 0.1 mg/kg. The sequence of laryngoscopy and orotracheal intubation was always performed in less than 20 seconds. The anesthesia was maintained by O2/N2O in IPPV (TV = 10 ml/kg; respiratory rate 12). Heart rate, systolic, diastolic and mean blood pressure were recorded at the following times: on arrival in the operating room (T-5), 3 minutes before laryngoscopy (T-3), just at laryngoscopy (T0) and 1 (T1), 3 (T3), 54 (T5) minutes after intubation. The comparison of baseline values (T-5) with T1 values showed that the heart rate did not change significantly in any group. Systolic blood pressure increased (p < 0.05) in SE group, decreased (p < 0.05) in AE and SE groups and did not change in AP and SP groups. Mean blood pressure increased in AE and SE groups, decreased in AP group but did not change significantly in SP group.(ABSTRACT TRUNCATED AT 250 WORDS)