Comparative effects of lidocaine, esmolol, and nitroglycerin in modifying the hemodynamic response to laryngoscopy and intubation

Journal of Clinical Anesthesia
H SinghP F White


To compare the safety and efficacy of lidocaine, esmolol, and nitroglycerin in modifying the hemodynamic response to laryngoscopy and intubation. Randomized, placebo-controlled, double-blind study. University-affiliated VA medical center. 40 ASA physical status I and II patients undergoing electric surgery with general endotracheal anesthesia. Anesthesia was induced with thiopental sodium 5 mg/kg, and intubation was facilitated with vecuronium 0.15 mg/kg. Isoflurane (0.5% to 1%) and 50% nitrous oxide in oxygen were used for maintenance of anesthesia. In addition, patients received one of the following four study drugs intravenously (i.v.) prior to laryngoscopy: Group 1 (control) = saline 5 ml; Group 2 = lidocaine 1.5 mg/kg; Group 3 = esmolol 1.4 mg/kg; Group 4 = nitroglycerin 2 micrograms/kg. Mean arterial pressure (MAP) and heart rate (HR) were recorded every minute for 20 minutes following induction of anesthesia. Following laryngoscopy and intubation, MAP increased significantly in all four treatment groups (control 49% +/- 19%, lidocaine 55% +/- 26%, esmolol 25% +/- 11%, nitroglycerin 45% +/- 21%) compared with preinduction baseline values. In the esmolol-pretreated patients, the increase in HR was significantly lower (20% ...Continue Reading


Sep 1, 1992·Journal of Clinical Anesthesia·K MikawaH Obara
Oct 1, 1991·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D R MillerJ Hill
Aug 1, 1990·British Journal of Anaesthesia·C D Miller, S J Warren
Apr 1, 1989·Acta Anaesthesiologica Scandinavica·T Nishikawa, A Namiki


Sep 4, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·David T Neilipovitz, Edward T Crosby
May 19, 2010·Annales Françaises D'anesthèsie Et De Rèanimation·A G M AyaJ Ripart
Aug 4, 1999·The Journal of Emergency Medicine·P MarikG L Sternbach
Dec 4, 2012·Emergency Medicine Clinics of North America·Eric HawkinsJane H Brice
Dec 17, 2015·Veterinary Anaesthesia and Analgesia·Ambra PantiLouise Clark
Sep 30, 2015·The Journal of Emergency Medicine·Joshua Bucher, Alex Koyfman
Oct 6, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Giovanni LandoniAlberto Zangrillo
Mar 26, 2011·Journal of Intensive Care Medicine·Christian ConsilvioGeoffrey K Lighthall
Aug 5, 2016·The Cochrane Database of Systematic Reviews·Na ZhaoYuguang Huang
Jan 13, 1999·European Journal of Anaesthesiology·A W WoodsJ A Davidson
Apr 2, 2015·American Journal of Therapeutics·Sang Hun KimSergio D Bergese
Sep 27, 2019·The Cochrane Database of Systematic Reviews·Hermann BlessbergerClemens Steinwender
Jul 5, 2013·The Cochrane Database of Systematic Reviews·Fauzia A Khan, Hameed Ullah

Related Concepts

Esmolol hydrochloride
Adrenergic beta-Antagonists
Anesthesia, Intravenous
Diastolic Blood Pressure
Double-Blind Method
Pulse Rate
Intubation, Intratracheal
Laryngoscopic Surgical Procedures
Lidocaine Monohydrochloride, Monohydrate

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.