Comparison of Diltiazem and Nicardipine for controlling the cardiovascular responses to tracheal intubation

Objective: To observe the efficacy of Nicardipine and Diltiazem in attenuation the cardiovascular responses to laryngoscopy and tracheal intubation(LTI).Methods: 60 patients of ASA Ⅰ-Ⅱ were assigned to one of the following 3 groups at random,normal saline(group C),0.2 mg/kg Diltiazem(group D) or 15 μg/kg Nicardipine(group N).The medication for study was administered intravenously 2 minutes before the initiation of LTI.Blood pressure(BP),heart rate(HR),stroke volume index(SVI) and cardiac index(CI) were recorded at designed time points,before induction,immediate and after the bolus injection,immediate and 1,2,3 min after LTI.Rate-pressure product(RPP) were calculated.Results: After intubation,the peak MAP and HR values in group C increased by 21.7% and 31.1% over the baseline values(P0.01);changes of MAP and HR after tracheal intubation in group D were less than those in group C(P0.05);In group N,the increase in MAP provoked by LTI were less than group C and HR increased by 42.5% over the baseline;CI,SVI increased slightly after the bolus of Diltiazem and Nicardipine.Conclusion: Nicardipine is effective in attenuating pressure response to tracheal intubation but can not prevent tachycardia;Diltiazem produced greater attenuation on the circulatory responses to tracheal intubation.