Turkish Journal of Anaesthesiology & Reanimation
ORIGINAL ARTICLE

Propofol Versus Thiopental for Rapid-Sequence Induction in Isolated Systolic Hypertensive Patients: A Factorial Randomized Double-Blind Clinical Trial

1.

Clinic of Anaesthesiology and Reanimation, Derindere Hospital, İstanbul, Turkey

2.

Department of Oral and Maxillofacial Surgery, Division of Anaesthesiology, Ankara University Faculty of Dentistry, Ankara, Turkey

3.

Department of Anaesthesiologu and Reanimation, Ankara University School of Medicine, Ankara, Turkey

Turk J Anaesthesiol Reanim 2018; 46: 367-372
DOI: 10.5152/TJAR.2018.44442
Read: 518 Downloads: 225 Published: 21 September 2019

Objective: We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients.

Methods: One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified according to the American Association of Anesthesiologists as Class II and III were randomized into four groups. After pre-oxygenation for 3 minutes, induction and tracheal intubation were performed by blinded investigators, who also scored the intubation. Study groups composed of 30 patients each received lidocaine 1 mg kg-1+thiopental 5 mg kg-1 or remifentanil 1 μg kg-1+thiopental 5 mg kg-1 or lidocaine 1 mg kg-1+propofol 2 mg kg-1 or remifentanil 1 μg kg-1+propofol 2 mg kg-1. Succinylcholine was the muscle relaxant. Haemodynamic data were obtained before (baseline) and after induction, at intubation, and at 1, 3, 5 and 10 minutes after intubation. A rise or drop in the arterial blood pressure and heart rate >20% were considered to be significant.

Results: Patients receiving remifentanil+propofol had a reduction in the systolic and mean blood pressure >20% when compared to patients receiving remifentanil and thiopental: systolic values were 125±27 mmHg in the remifentanil+propofol group versus 153±35 mmHg in the remifentanil+thiopental group 1 minute after intubation (p<0.01); the mean arterial pressure values were 87±18 mmHg in the remifentanil+propofol group versus 105±25 mmHg in the remifentanil+thiopental group 1 minute after intubation (p<0.05).

Conclusion: Propofol was not superior to thiopental for the attenuation of the response to laryngoscopy and intubation during RSI in systolic hypertensive patients, whereas propofol+remifentanil combination appears to be so in terms of the heart rate stability.

 

Cite this article as: Aslan NA, Vural Ç, Yılmaz AA, Alanoğlu Z. Propofol Versus Thiopental for Rapid-Sequence Induction in Isolated Systolic Hypertensive Patients: A Factorial Randomized Double-Blind Clinical Trial. Turk J Anaesthesiol Reanim 2018; 46(5): 367-72.

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