Department of Anesthesia, Gifu Red Cross Hospital, Gifu, 502-8511, Japan.
J Anesth. 2010 Apr;24(2):168-72. doi: 10.1007/s00540-010-0879-4. Epub 2010 Feb 20.
Either the calcium (Ca(2+))-channel blocker nicardipine or the beta(1)-adrenoceptor antagonist landiolol may be intravenously (IV) administered to reduce the hemodynamic responses to tracheal intubation. In this study, we examined the effects of these drugs on the yawning response elicited by intravenous thiopental in humans.
After Institutional Review Board approval, 180 consenting American Society of Anesthesiologists (ASA) I or II patients undergoing elective surgery were recruited. In a double-blind, randomized design, three groups of 60 patients each received one of the following intravenous injections: (1) landiolol 0.1 mg/kg (L-group), (2) nicardipine 0.02 mg/kg (N-group), or (3) saline (S-group). In all patients, anesthesia was subsequently induced IV with 4 mg/kg thiopental. Thereafter, the occurrence of the yawning response (characterized by mouth opening) was continuously assessed as the only clinical endpoint for 1 min. Throughout the study, mean arterial blood pressure and heart rate were also recorded at 1-min intervals.
The incidence of the yawning response was lower in both the L-group (6.7%) and the N-group (16.7%) than in the S-group (46.7%) (each, P < 0.01).
Prior intravenous administration of either a Ca(2+)-channel blocker or a beta(1)-adrenoceptor antagonist can greatly reduce the thiopental-induced yawning response in humans.
钙通道阻滞剂尼卡地平或β1-肾上腺素受体拮抗剂拉贝洛尔均可静脉内(IV)给药以减轻气管插管引起的血流动力学反应。在这项研究中,我们检查了这些药物对静脉注射硫喷妥钠引起的人类哈欠反应的影响。
在机构审查委员会批准后,招募了 180 名同意接受择期手术的美国麻醉医师协会(ASA)I 或 II 级患者。在一项双盲、随机设计中,三组 60 名患者分别接受以下静脉注射之一:(1)拉贝洛尔 0.1mg/kg(L 组),(2)尼卡地平 0.02mg/kg(N 组)或(3)生理盐水(S 组)。在所有患者中,均通过 IV 给予 4mg/kg 硫喷妥钠诱导麻醉。此后,连续评估 1 分钟作为唯一的临床终点评估哈欠反应(以张口为特征)的发生情况。在整个研究过程中,每隔 1 分钟记录平均动脉血压和心率。
L 组(6.7%)和 N 组(16.7%)的哈欠反应发生率均低于 S 组(46.7%)(每组,P <0.01)。
预先静脉内给予钙通道阻滞剂或β1-肾上腺素受体拮抗剂均可大大降低人类硫喷妥钠诱导的哈欠反应。