Effects of Esmolol, Lidocaine and Fentanyl on P Wave Dispersion, QT, QTc Intervals and Hemodynamic Responses to Endotracheal Intubation During Propofol Induction: a Comparative Study

摘要

Background and objectives In our study we aimed to investigate the effect of esmolol, lidocaine and fentanyl on P-wave dispersion (Pwd), QT and corrected QT (QTc) durations and hemodynamic responses to endotracheal intubation during propofol induction. Methods A total of eighty adult patients, American Society of Anesthesiologists (ASA) Physical Status I or II aged 18 to 60 years were included in this prospective, randomised, double-blind study. All patients had control electrocardiograms (ECGs) done before anesthesia induction. The patients were randomised into four equal groups. The control group (Group C) received saline 5 mL, the esmolol group (Group E) received esmolol 0.5 mg.kg -1 , the fentanyl group (Group F) received fentanyl 2 μg.kg -1 and the lidocaine group (Group L) received lidocaine 1.5 mg.kg -1 before anesthesia induction. Anesthesia was induced with intravenous propofol. ECGs for all patients were performed during the 1 st and 3 rd minutes of induction, 3 minutes after administration of muscle relaxant, and at 5 minutes and 10 minutes after intubation. Pwd and QT intervals were measured on all ECGs. QTc intervals were determined using the Bazett formula. Heart rate (HR) and mean arterial pressure (MAP) were recorded before and after induction of anesthesia, immediately after intubation, and 1, 3, 5, 7 and 10 minutes after intubation. Results Compared with control, HR signi?cantly increased in Group C, Group L and Group F after intubation. However, in Group E, there was no signi?cant difference in HR values between control and after intubation. Compared with control, MAP signi?cantly increased in Group C and Group L after the intubation. However, in Group E and Group F, there was no signi?cant difference in MAP values between control and after the intubation. Compared with control, Pwd signi?cantly increased in Group C after intubation. In Group L, Group F and Group E, there was no signi?cant difference in Pwd values between control and after the intubation. Compared with control, QTc duration signi?cantly increased in Group C and L after the intubation. In Group F and Group E, there was no signi?cant difference in QTc durations between control and after the intubation. Conclusion We concluded that administration of esmolol before intubation prevents tachycardia and an increase in MAP, Pwd and QTc duration caused by laryngoscopy and tracheal intubation.