K S Chung1, R S Sinatra, J H Chung. 1. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT.
Abstract
STUDY OBJECTIVE: To evaluate the efficacy of an intermediate dose of labetalol (0.4 mg/kg) for attenuation of heart rate (HR) and blood pressure (BP) responses to laryngoscopy and intubation. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING:Inpatient gynecology service at a university medical center. PATIENTS: Two groups of 18 patients each undergoing elective surgery under general anesthesia. INTERVENTIONS: Patients received either 0.4 mg/kg of labetalol or an equal volume of normal saline 5 minutes prior to laryngoscopy and intubation. MEASUREMENTS AND MAIN RESULTS:HR and BP were measured upon arrival in the operating room (OR) (baseline) and at 1 minute intervals thereafter for 4 minutes prior to intubation and through 10 minutes following intubation. The labetalol group had a significantly lower HR from induction through 1 minute following intubation. Intragroup differences in HR were greatest immediately following laryngoscopy and intubation (33% increase above baseline for the placebo group vs 1% for the labetalol group, p less than 0.05). At the same time, a significant increase in mean arterial pressure (MAP) from baseline was noted in both groups (29% for the placebo group vs 23% for the labetalol group), but the difference between the groups was not significant. CONCLUSIONS: An intermediate dose of labetalol blunted the HR response to laryngoscopy and intubation during rapid-sequence induction in healthy patients but had a minimal effect on BP.
RCT Entities:
STUDY OBJECTIVE: To evaluate the efficacy of an intermediate dose of labetalol (0.4 mg/kg) for attenuation of heart rate (HR) and blood pressure (BP) responses to laryngoscopy and intubation. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Inpatient gynecology service at a university medical center. PATIENTS: Two groups of 18 patients each undergoing elective surgery under general anesthesia. INTERVENTIONS:Patients received either 0.4 mg/kg of labetalol or an equal volume of normal saline 5 minutes prior to laryngoscopy and intubation. MEASUREMENTS AND MAIN RESULTS: HR and BP were measured upon arrival in the operating room (OR) (baseline) and at 1 minute intervals thereafter for 4 minutes prior to intubation and through 10 minutes following intubation. The labetalol group had a significantly lower HR from induction through 1 minute following intubation. Intragroup differences in HR were greatest immediately following laryngoscopy and intubation (33% increase above baseline for the placebo group vs 1% for the labetalol group, p less than 0.05). At the same time, a significant increase in mean arterial pressure (MAP) from baseline was noted in both groups (29% for the placebo group vs 23% for the labetalol group), but the difference between the groups was not significant. CONCLUSIONS: An intermediate dose of labetalol blunted the HR response to laryngoscopy and intubation during rapid-sequence induction in healthy patients but had a minimal effect on BP.
Authors: Hermann Blessberger; Sharon R Lewis; Michael W Pritchard; Lizzy J Fawcett; Hans Domanovits; Oliver Schlager; Brigitte Wildner; Juergen Kammler; Clemens Steinwender Journal: Cochrane Database Syst Rev Date: 2019-09-26