Preoperative beta-blockade for patients undergoing craniotomy: a comparison between propranolol and atenolol

Allberry, Richard A. W.; Drake, H.

doi:10.1007/bf03005625

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Orally administered Atenolol given before the surgery could reduce the pressure responses to laryngeal instrumentation and endotracheal (ET) intubation in neurosurgical patients. [12] Clonidine in single preoperative dose of 300 µ g is found to blunt haemodynamic response to micro-laryngoscopy, bronchoscopy, and during cardiopulmonary bypass with less frequent ventricular arrhythmias. [1314]…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study

et al. 2011

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Severe cardiovascular responses in the form of tachycardia and hypertension following nasal speculum insertion occur during sublabial rhinoseptal trans-sphenoid approach for resection of small pituitary tumours. We compare the effects of preoperative administration of clonidine (α-2 agonist) and atenolol (α-blocker) over haemodynamic response, caused by speculum insertion during trans-sphenoid pituitary resection. We enrolled 66 patients in age range 18-65 years, of ASA I–II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy. Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg. The heart rate increased on speculum insertion and 5 and 10 minutes following speculum insertion as compared to the pre-speculum values in the control group, while no change in the heart rate was observed in other groups (P<0.05). There was a rise in the mean arterial pressure during and 5, 10, and 15 minutes after nasal speculum insertion in the control group, whereas it was not seen in other groups (P<0.05). We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

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Section: Discussionmentioning

confidence: 99%

Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study

et al. 2011

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“…[2,7,11,12,13,19,20,23]. Auch bei den oral verabreichten, länger wirksamen kardioselektiven Betarezeptorenantagonisten sind die Daten uneinheitlich: Atenolol und Propanolol verminderten die durch den Intubationsstress verursachte Hypertonie und Tachykardie, während Metoprolol und Practolol keine Wirksamkeit zeigten [1]. Dies lässt den Schluss zu, dass die schlechtere Wirksamkeit von Esmolol nicht auf eine Unterdosierung zurückzuführen ist.…”

Section: Messwerte 10 Min Nach Intubationunclassified

Kardiovaskuläre Stressprotektion während der Anästhesieeinleitung

et al. 2001

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Alpha-2-adrenoceptor-agonists as well as cardioselective betareceptor-antagonists have been shown to blunt stress response due to tracheal intubation. The purpose of our study was to investigate,whether clonidine or esmolol is more efficient to attenuate stress response due to intubation.44 patients were randomly assigned to receive either clonidine (n=22; 3 microg/kg) or esmolol (n=22; 2 mg/kg) immediately prior to a standardized induction of anaesthesia. Heart rate, arterial blood pressure, cardiac output, epinephrine and norepinephrine plasma concentrations were measured before,during and 10 min after intubation. Blood pressure was measured invasively and cardiac output was determined by transthoracic echocardiography. Absolute values and increase of mean arterial pressure and norepinephrine plasma concentrations were significantly less in the clonidine group (p<0,05). Clonidine (3 microg/kg) is more efficient than esmolol (2 mg/kg) in blunting stress response due to endotracheal intubation.

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“…Other drugs used at induction (β‐blockers, calcium antagonists, lidocaine) and the fact that these drugs are used more frequently if the patient is known to have ischaemic heart disease, suggest that there is an attempt to reduce cardiovascular stimulation. Most of these drugs have been shown to achieve this [25–28] and combinations may be most effective [29, 30]. In spite of this, there is little evidence that reducing tachycardia and hypertension due to intubation is beneficial.…”

Section: Discussionmentioning

confidence: 99%

Rapid sequence induction: a national survey of practice

Morris

Cook

2001

Anaesthesia

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We performed a national postal survey exploring anaesthetists' practice in rapid sequence induction. All respondents used pre‐oxygenation, although the technique employed, and its reliability, varied. Thiopental and succinylcholine, given after waiting for signs of loss of consciousness, were the most widely used drugs for rapid sequence induction. Propofol and rocuronium were used by more than a third of respondents, and most respondents (75%) also routinely administered an opioid. Cricoid pressure was used universally but the practice of its application varied widely. The commonest aids used if intubation was difficult were the gum elastic bougie, the long laryngoscope blade and the laryngeal mask. After failed intubation, approximately half of respondents would maintain the supine position. Failure to intubate at rapid sequence intubation had been seen by 45% of respondents but harm was uncommon. In contrast, 28% had seen regurgitation, which frequently led to considerable harm and to three deaths. In spite of this, practice of a failed intubation drill was uncommon (15%) and anaesthetic assistants were rarely known to practice application of cricoid pressure. Consultants were less likely than trainees to use rocuronium as a muscle relaxant, and more likely to choose morphine if administering an opioid. They were less likely to practice a failed intubation drill. Other aspects of practice varied little between grades. This survey suggests that many anaesthetists do not follow best practice when performing a rapid sequence induction.

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Preoperative beta-blockade for patients undergoing craniotomy: a comparison between propranolol and atenolol

Abstract: This study was undertaken to establish if beta-blocking drugs

Cited by 8 publications

References 16 publications

Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study

Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study

Kardiovaskuläre Stressprotektion während der Anästhesieeinleitung

Rapid sequence induction: a national survey of practice

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