Comparison of the effects of intravenous alfentanil and esmolol on the cardiovascular response to double-lumen endobronchial intubation

We compared the effect of alfentanil 10 mug.kg(-1) and esmolol 1.5 mg.kg(-1 ) on the cardiovascular responses to laryngoscopy and double-lumen endobron chial intubation in two groups of 20 ASA 2-3 patients undergoing pulmonary surgery, in a randomised double-blind study. Arterial pressure and heart ra te decreased after induction of anaesthesia and increased after intubation in both groups (p < 0.05) but remained at or below baseline values, and cha nges were comparable in both groups. Plasma catecholamine concentrations de creased after induction of anaesthesia in both groups (p < 0.05). Epinephri ne concentrations increased in the esmolol group after intubation (p < 0.05 ) but remained below baseline in the alfentanil group (p < 0.05). Norepinep hrine concentrations increased significantly in both groups after intubatio n but were higher in the esmolol group (p < 0.05). Although both esmolol 1. 5 mg.kg(-1) and alfentanil 10 mug.kg(-1) similarly attenuated the arterial pressure and heart rate response to endobronchial intubation, plasma catech olamine concentrations increased in the esmolol group to values greater tha n previously reported after tracheal intubation.