Effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation.

OBJECTIVE: To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. METHODS: Thirty-five adult patients were randomly allocated to one of three groups, Group A (control group). Group B (esmolol group) and Group C (alfentanil group). The patients received either 2 mg/kg esmolol (in Group B) or 30 microg/kg alfentanil (in Group C) before intubation. Tracheal intubation was performed with 4 mg/kg thiopental and 0.1 mg/kg vecuronium and 3% isoflurane. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR), norepinephrine (NE), epinephrine (E) and dopamine (DA) were measured before and after intubation. RESULTS: The control group had a baseline SBP of 149 +/- 23 mmHg while Groups B, C had a baseline SBP of 148 +/- 23, and 150 +/- 21 mmHg, respectively (P>0.05). Three min after tracheal intubation, the control group SBP increased to 160 +/- 30 mmHg and Group B remained at the baseline level, 147 +/- 5 mmHg, and Group C significantly decreased to 91 +/- 22 mmHg (P<0.01). Two min after intubation HR in Group B increased significantly but 3 min after intubation HR in Groups B and C were significantly lower than that of control group (P<0.05). NE in Groups A and B increased significantly to 5.75 +/- 3.51 and 6.75 +/- 3.30 nmol/L 3 min after intubation (P<0.01). In Group C, 3 min after intubation NE was not significantly different from the baseline but E decreased significantly (P<0.01). CONCLUSION: 2 mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30 microg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.