ATTENUATION OF PRESSURE RESPONSES TO TRACHEAL INTUBATION USING TOPICAL NITROGLYCERINE AND INTRAVENOUS DILTIAZEM

Dr Kavyashree M; Dr Prasad Kulkarni; Dr Shailesh Kumar; Dr Shobha G Potdar; Dr Channagouda Hadimani; Dr Akhil Rao U. K.

Volume : VI, Issue : V, May - 2017

ATTENUATION OF PRESSURE RESPONSES TO TRACHEAL INTUBATION USING TOPICAL NITROGLYCERINE AND INTRAVENOUS DILTIAZEM

Dr Kavyashree M, Dr Prasad Kulkarni, Dr Shailesh Kumar, Dr Shobha G Potdar, Dr Channagouda Hadimani, Dr Akhil Rao U. K.

Abstract :

In order to attenuate the pressure responses to tracheal intubation, we have studied the effects of intravenous diltiazem 0.2mg/kg and transdermal nitroglycerine sustained release infusion system of 0.4mg/hour, applied one hour before intubation. A study was conducted with randomised design in 150 patients, 50 patients formed the control group, 50 patients received intravenous diltiazem 0.2mg/kg and the rest of the 50 patients received transdermal nitroglycerine infusion system. The maximum rise in systolic blood pressure was significantly lower in both nitroglycerine group (12%) and diltiazem group (5%) as compared to control group (29%) at intubation. Rise in arterial pressure persisted beyond 5 minutes in control group, whereas in nitroglycerine group and diltiazem group systolic pressure reduced to baseline value by 5 minutes . Pulse rate, however, increased in all three groups to an equal extent. We have found that application of nitroglycerine transdermal infusion system and intravenous diltiazem is a safe, inexpensive means of attenuating the pressure response to intubation of trachea.