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 responsee to tracheal intubation.Mahods. Thirty-five adult patients were randomly allocated to one of three groups, Group A (control group), Group B (esmolol groap) and Group C (alfentanil group). The patients received either 2 mg/kg esmolol (in Group B) or 30μg/kg alfentanil (in Group C) before intulmtion. 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 intubtttion.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±21mmHg,respectively(P>0.05),Three min after tracheal intubation,the control group SBP increased to 160±30mmHg and Group B remained at the baseline level ,147±5mmHg,and Goup C significantly decreased to 91±22mmHg(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 significatly to 5.75±3.51 and 6.75±3.30nmol/L 3 min after intubation(P<0.01).In Group C,3min after intubation NE was not significantly different from the baseline but E becreased significantly(P<0.01).Conclusion.2mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30μg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.

完成机构：DepartmentofAnesthesiology,PekingUnionMedicalCollegeHospital,CAMS＆PUMC,Beijing100730