Mikawa K, Maekawa N, Hasegawa M, Kaetsu H, Goto R, Yaku H, Takao Y, Nishina K, Obara H
Department of Anaesthesiology, Kobe University School of Medicine, Japan.
Anesth Analg. 1993 Mar;76(3):585-91. doi: 10.1213/00000539-199303000-00024.
We conducted a randomized, placebo-controlled, and double-blind study to evaluate the efficacy of oral guanabenz, an alpha 2-adrenergic agonist, in attenuating the cardiovascular and catecholamine responses to laryngoscopy and tracheal intubation in 30 normotensive (ASA physical status 1) patients undergoing elective surgery. They were allocated to one of three groups (n = 10 for each): placebo, 4 mg, or 6 mg of guanabenz groups. These tablets were administered 2 h before the induction of anesthesia. Anesthesia was induced with thiopental 5.0 mg/kg intravenously (IV), and tracheal intubation was facilitated by the administration of vecuronium, 0.2 mg/kg IV. During anesthesia, ventilation was assisted or controlled with 1% enflurane and 50% nitrous oxide in oxygen. Laryngoscopy lasting 30 s was attempted 2 min after the administration of thiopental and vecuronium. Patients receiving placebo showed a significant increase in mean arterial blood pressure, heart rate, and plasma catecholamine concentrations in response to tracheal intubation. These changes were significantly smaller in patients receiving either dose of guanabenz (P < 0.05). Oral administration of guanabenz before induction of anesthesia is a simple and effective method for attenuating the pressor and tachycardic responses to laryngoscopy and tracheal intubation with the drug acting at least partly via inhibition of the increases in plasma catecholamines concentrations.
我们进行了一项随机、安慰剂对照、双盲研究，以评估α2 - 肾上腺素能激动剂口服胍法辛在减轻30例接受择期手术的血压正常（美国麻醉医师协会身体状况分级为1级）患者对喉镜检查和气管插管的心血管及儿茶酚胺反应方面的疗效。他们被分为三组之一（每组n = 10）：安慰剂组、4 mg胍法辛组或6 mg胍法辛组。这些片剂在麻醉诱导前2小时服用。静脉注射硫喷妥钠5.0 mg/kg诱导麻醉，静脉注射维库溴铵0.2 mg/kg辅助气管插管。麻醉期间，用1%恩氟烷和50%氧化亚氮与氧气混合进行辅助或控制通气。在注射硫喷妥钠和维库溴铵2分钟后尝试进行持续30秒的喉镜检查。接受安慰剂的患者在气管插管时平均动脉血压、心率和血浆儿茶酚胺浓度显著升高。接受任何一种剂量胍法辛的患者这些变化均显著较小（P < 0.05）。麻醉诱导前口服胍法辛是减轻对喉镜检查和气管插管的升压及心动过速反应的一种简单有效的方法，该药物至少部分通过抑制血浆儿茶酚胺浓度升高起作用。
