Mikawa K, Hasegawa M, Suzuki T, Maekawa N, Kaetsu H, Goto R, Yaku H, Obara H
Department of Anesthesiology, Kobe University School of Medicine, Japan.
J Clin Anesth. 1992 Sep-Oct;4(5):367-71. doi: 10.1016/0952-8180(92)90157-v.
To evaluate the efficacy and safety of intravenous (IV) nitroglycerin in attenuating the hypertensive response to laryngoscopy and intubation as a new application of the drug.
Controlled, randomized, double-blind study.
University hospital.
Thirty normotensive patients (ASA physical status I) undergoing elective surgery were divided into three groups of ten patients each.
Anesthesia was induced with thiopental sodium 5 mg/kg i.v., and tracheal intubation was facilitated with vecuronium 0.2 mg/kg i.v. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Either 1.5 micrograms/kg of nitroglycerin, 2.5 micrograms/kg of nitroglycerin, or saline (control) was administered IV simultaneously with the start of laryngoscopy (lasting 30 seconds), which was attempted 2 minutes after administration of thiopental sodium and vecuronium.
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 significantly reduced in nitroglycerin-treated patients compared with those in the control group (p < 0.05).
A single, rapid IV dose of nitroglycerin is a simple, practical, effective, and safe method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.
评估静脉注射硝酸甘油作为一种新的应用方式，在减轻喉镜检查和气管插管引起的高血压反应方面的疗效和安全性。
对照、随机、双盲研究。
大学医院。
30例接受择期手术的血压正常患者（ASA身体状况I级）被分为三组，每组10例。
静脉注射硫喷妥钠5mg/kg诱导麻醉，静脉注射维库溴铵0.2mg/kg辅助气管插管。麻醉期间，用1%安氟醚和50%氧化亚氮与氧气混合进行辅助通气或控制通气。在喉镜检查开始时（持续30秒），静脉同时注射1.5μg/kg硝酸甘油、2.5μg/kg硝酸甘油或生理盐水（对照组），喉镜检查在注射硫喷妥钠和维库溴铵2分钟后进行。
接受生理盐水的患者在气管插管时平均动脉压和心率-血压乘积显著升高。与对照组相比，硝酸甘油治疗组患者气管插管后的这些升高显著降低（p<0.05）。
单次快速静脉注射硝酸甘油是减轻喉镜检查和气管插管引起的高血压反应的一种简单、实用、有效且安全的方法。
