Prevention and Treatment of Hemodynamic Pressor Response at the Stage of Induction of Anesthesia and Tracheal Intubation in Elderly Patients

O.A. Loskutov, O.M. Druzina, V.H. Kolesnykov, O.E. Domoratskyi

Abstract


This work deals with the assessment of balance of pressor hemodynamic responses on the stage of induction of anesthesia and tracheal intubation in elderly patients, their prevention and treatment. The study included 47 patients with ischemic heart disease, who underwent coronary artery bypass grafting. The average age of the patients was 69.3 ± 4.5 years, the average weight — 82.5 ± 7.4 kg. Depending on the method of the prevention and treatment of pressor reactions occurred in patients at the stage of tracheal intubation, all patients were divided into three groups. The first group (n = 12) consisted of patients, in whom we have used 2% lidocaine solution (100 mg) for the irrigation of vocal cords before introduction of the endotracheal tube. The second group (n = 18) consisted of patients, who were administered urapidil in a dose of 15–20 mg at the stage of laryngoscopy. In the third group of examinees (n = 17), a deepening of anesthesia was performed by additional fentanyl and propofol administration. In all patients at the stage of laryngoscopy, blood pressure (BP) increased by 23.6 ± 3.2 % from baseline. Immediately after intubation, in the first and third groups a further increase of systolic BP occurred, while in group 2, in which urapidil prophylactic administration was used, BP was lower by an average of 27.4 ± 2.6 % compared with BP values recorded in the first and third groups. Thus, patients with arterial hypertension at the stage of laryngoscopy and tracheal intubation are subject to pronounced hemodynamic pressor responses, for the prevention and treatment of which the introduction of urapidil is the most effective method.


Keywords


arterial hypertension; elderly patients; anesthesia; pressor response during intubation

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DOI: https://doi.org/10.22141/2224-0586.5.76.2016.76434

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