Original contribution
Effect of labetalol or lidocaine on the hemodynamic response to intubation: A controlled randomized double-blind study

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Abstract

Labetalol, a combined alpha 1- and nonselective beta-adrenergic blocking drug, was compared to lidocaine or saline to minimize the hypertensive and tachycardic response to intubation in a controlled randomized double-blind study in patients undergoing surgical procedures under general anesthesia. Forty adult patients were divided into four groups of 10 each: placebo (saline), lidocaine 100 mg, labetalol 5 mg, or labetalol 10 mg. The double-blind preparation was administered as an IV bolus just prior to induction and 2 min before the stimulus of laryngoscopy and intubation. Heart rate and blood pressure were measured at 1-min intervals for 2 min prior to induction of anesthesia and through 6 min following induction of anesthesia. Labetalol 10 mg prevented a rise in heart rate after intubation compared to patients who received placebo, lidocaine 100 mg, or labetalol 5 mg. The hypertensive response to intubation was similar in all four groups. Labetalol 10 mg IV just prior to induction of anesthesia is a safe and cost-effective means of preventing tachycardia but not hypertension in response to laryngoscopy and intubation.

References (28)

  • B. Chraemmer-Jorgensen et al.

    Lack of effect of intravenous lidocaine on hemodynamic responses to rapid sequence induction of general anesthesia: a double-blind controlled clinical trial

    Anesth Analg

    (1986)
  • E.P. MacCarthy et al.

    Labetalol: a review of its pharmacology, pharmacokinetics, clinical uses, and adverse effects

    Pharmacotherapy

    (1983)
  • J.B. Leslie et al.

    Intravenous labetalol for treatment of postoperative hypertension

    Anesthesiology

    (1987)
  • L. Saarnivaara et al.

    Labetalol as a hypotensive agent for middle ear microsurgery

    Acta Anaesthesiol Scand

    (1987)
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      Acting as a cerebral vasodilator, nicardipine is a dihydropyridine calcium channel blocker that increases stroke volume and coronary blood flow without changing intracranial volume or pressure.14 Previous studies have established the efficacy and tolerability of labetalol7–11 and nicardipine13,16–18 for the prevention of detrimental cardiovascular changes during LTI. We searched PubMed from January 1895 to December 2009 using the terms: nicardipine, labetalol, hypertension, and intubation but no study that compared the use of labetalol and nicardipine for the prevention and treatment of adverse cardiovascular response during LTI was found.

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    Assistant Professor of Anesthesia, lchihara Hospital, University of Teikyo Medical School, Japan

    Professor of Anaesthesia, Massachusetts General Hospital and Harvard Medical School, Boston, MA

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    Associate Professor of Anaesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, MA

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