Hemodynamic response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with different concentrations of sevoflurane

Study Objective: To evaluate the blood pressure (BP) and heart rate (HR) re sponse to tracheal intubation after vital capacity rapid inhalation inducti on (VCRII) with four concentrations of sevoflurane followed by nitrous oxid e (N2O) 50% and sevoflurane in concentrations administered by clinical judg ment. Design: Prospective, randomized study. Setting: University: teaching hospital. Patients: 60 unpremedicated, ASA physical status I and II adult patients un dergoing surgery with general anesthesia. Interventions: After fentanyl 3 mu g/kg, VCRII was accomplished with four c oncentrations of sevoflurane in O-2: Group 1 (n = 15): sevoflurane 3%; Grou p 2 (n = 15): sevoflurane 4%; Group 3 (n = 15): seroflurane 5%; and Group 4 (n = 15): sevoflurane 6%. At loss of consciousness, rocuronium 0.6 mg/kg w as given, and intubation was performed 90 seconds later. Thereafter, anesth esia continued with N2O 50% and sevoflurane. Measurements and Main Results: BP and HR measurements were made at the ward (baseline), at loss of consciousness, and just prior to, and each minute a fter, tracheal intubation during a 5-minute period. The hemodynamic profile among groups was similar, with a slight hypertensive and tachycardic respo nse to intubation. Conclusion: VCRII with sevoflurane 3% to 6% following fentanyl 3 mu g/kg. c an be considered for blunting the hemodynamic response to tracheal intubati on in healthy patients. (C) 1999 by Elsevier Science Inc.