七氟醚静吸复合麻醉与全凭静脉麻醉用于小儿手术的比较

目的 比较七氟醚静吸复合麻醉与丙泊酚、芬太尼全凭静脉麻醉用于小儿手术的临床效果.方法 60例4～14岁ASA Ⅰ级择期行外科手术的小儿,随机均分为丙泊酚、芬太尼全凭静脉麻醉组(丙泊酚组)和七氟醚静吸复合麻醉组(七氟醚组).丙泊酚组静脉麻醉诱导,静脉麻醉药物维持.七氟醚组七氟醚麻醉诱导,七氟醚麻醉维持.记录术中血流动力学变化,术后麻醉恢复情况.结果 两组诱导方法都能实现快速诱导,且丙泊酚组麻醉诱导起效更快,意识消失时间、插管时间较七氟醚组缩短(P＜0.01).而七氟醚组麻醉诱导对心率的影响更小,诱导更平稳.七氟醚组苏醒时间、拔管时间、定向力恢复时间和PACU滞留时间均短于丙泊酚组(P＜0.01).结论 七氟醚静吸复合麻醉后术中循环稳定,术后清醒迅速、平稳,可安全有效地应用于小儿手术.     

七氟醚吸入用于人工流产术的麻醉

目前门诊无痛人工流产术常采用丙泊酚或丙泊酚复合芬太尼或雷米芬太尼麻醉。七氟醚是一种新型的吸入麻醉药，具有无刺激性气味、对呼吸循环抑制轻以及诱导快、苏醒迅速完全等特点。本研究观察七氟醚用于门诊人工流产术时病人的诱导速度、苏醒时间、定向力恢复时间、术中肢动情况以及血流动力学和呼吸的变化，现报道如下。     

芬太尼复合七氟醚诱导无肌松插管的量效关系

目的 观察芬太尼复合七氟醚诱导无肌松插管的半数有效量(ED_(50)).方法 择期短小手术患者26例,ASA Ⅰ-Ⅱ,年龄25～45岁纳入研究.8%七氟醚肺活量诱导,跟睑反射消失后,维持呼气末七氟醚浓度3%,按照改良Dixon序贯法调整芬太尼剂量(剂量梯度为0.4 μg/kg),静脉注射芬太尼4 min后气管插管.记录麻醉诱导前平均动脉压(MAP)、心率(HR)和熵指数(Entropy indices)的基础值以及捅管前后1 min及插管后3 min的变化.结果 8%七氟醚诱导,维持呼气末浓度3%,成功无肌松气管插管的芬太尼ED_(50)为(1.2±0.3)μg/kg,采用probit分析方法 芬太尼ED_(50)和ED95及(95%可信区间)分别为1.2 μg/kg(0.9～1.6) μg/kg和1.9 μg/kg(1.6～3.9) μg/kg.结论 8%七氟醚肺活量诱导,维持呼气末七氟醚浓度3%,无肌松满意气管插管的芬太尼ED_(50)为(1.2±0.3)μg/kg.     

心脏瓣膜置换术中七氟醚复合麻醉对血流动力学的影响

报告了七氟醚－芬太尼麻醉对二尖瓣置换术患者血流动力学的影响。８例行二尖瓣置换术患者，芬太尼、阿屈可林诱导后，以低浓度（≤１ＭＡＣ）七氟醚维持麻醉。分别于诱导前、后，吸入七氟醚后，切皮、锯胸骨、腔静脉插管、停体外循环及关胸后测定血流动力学变化。结果表明，吸入七氟醚后，心率（ＨＲ）减慢，平均动脉压（ＭＡＰ）呈一过性降低（Ｐ＜０．０５），每搏指数（ＳＩ）增加。术中循环功能稳定，复跳后未见严重心律紊乱。认为在芬太尼静脉麻醉基础上吸入低浓度七氟醚，对心脏瓣膜置换手术是安全的麻醉方法。     

喉罩通气全凭吸入七氟醚麻醉用于乳腺癌改良根治术的临床观察

目的 探讨喉罩通气全凭吸入七氟醚麻醉用于乳腺癌改良根治术的临床效果.方法 择期乳腺癌手术患者60例,随机均分为全凭吸入七氟醚组(A组)和传统静吸复合组(B组).两组术前均给予盐酸戊乙奎醚1 mg肌注,咪唑安定2 mg静注.A组给予单纯七氟醚吸入诱导,置入喉罩成功后连接麻醉机机械控制呼吸,麻醉维持采用单纯七氟醚吸入;B组给予芬太尼4μg/kg、丙泊酚1 mg/kg、顺苯磺酸阿曲库铵0.15 mg/kg静注麻醉诱导,置入喉罩成功后连接麻醉机机械控制呼吸,麻醉维持采用七氟醚持续吸入,间断注射顺苯磺酸阿曲库铵维持肌松.监测两组患者不同时点的BP、HR、SpO2等指标.记录两组患者麻醉诱导至成功置入喉罩的时间和手术结束至拔除喉罩的时间.结果 两组患者在麻醉诱导置入喉罩时的心血管反应差异无统计学意义,麻醉开始诱导至睫毛反射消失的时间差异无统计学意义,术中生命体征差异亦无统计学意义,但手术结束至拔除喉罩的时间A组明显短于B组(P＜0.05).结论 乳腺癌改良根治术采用喉罩通气全凭吸入七氟醚麻醉,麻醉诱导及苏醒迅速,能满足喉罩置入及外科手术操作的麻醉要求,并且操作方便、安全性高.     

地氟醚与七氟醚麻醉对老年病人术后认知功能的影响

目的 探讨地氟醚及七氟醚复合麻醉对老年病人术后认知功能恢复的影响。方法 70例择期行全膝或全髋关节置换术的病人,年龄均在65岁以上。静注芬太尼、异丙酚、琥珀胆碱快速诱导插管后随机分为地氟醚和异氟醚组。麻醉诱导前及手术后1、3、6及24h应用Mini-Mental State（MMS）测试方法评定其认知功能。结果 与术前相比,两组病人术后1h MMS值均明显降低。地氟醚组由29.5±0.5降至27.8±1.7;七氟醚组由29.2±1.0降至27.4±1.7。其中85％以上病人术后3h MMS恢复至术前水平。两组病人术前及术后1、3、6及24h MMS比较均无显著差异。结论 老年病人应用地氟醚或七氟醚麻醉,其术后认知功能恢复相似,仅有一过性认知障碍。     

七氟醚吸入用于人工流产术的麻醉

目前门诊无痛人工流产术常采用丙泊酚或丙泊酚复合芬太尼或雷米芬太尼麻醉。七氟醚是一种新型的吸入麻醉药,具有无刺激性气味、对呼吸循环抑制轻以及诱导快、苏醒迅速完全等特点。本研究观察七氟醚用于门诊人工流产术时病人的诱导速度、苏醒时间、定向力恢复时间、术中肢动情况以及血流动力学和呼吸的变化,现报道如下。资料与方法一般资料早孕病人20例,年龄(26.65±4.00)岁,ASA均为Ⅰ级。麻醉方法专用挥发罐通过面罩吸入七氟醚,诱导浓度为6%~8%七氟醚和5L/min氧流量以半开放模式吸入,待病人意识消失后改用2%~3%七氟醚和3L/min氧流量以半紧…     

异氟醚静脉复合麻醉在心脏手术中的应用

用异氟醚静脉复合麻醉于心内直视手术20例。先静注γ-OH40mg/kg或安定0.1mg/kg,吸入0.2-2％异氟醚(半紧闭法),再静注琥珀胆碱1mg/kg和芬太尼2μg/kg,气管插管。继用0.4-1.0％异氟醚(紧闭法)维持麻醉。切皮前再静注首次剂量1/2芬太尼。用Normac测定呼气末异氟醚浓度,Nccom3测量心排血量等循环功能指标。结果表明,麻醉各阶段平均呼气末浓度为0.5MAC,最高0.84MAC,最低0.38MAC。异氟醚对循环功能抑制小,复合静脉麻醉可维持适当麻醉深度,避免异氟醚增侠心率相降低平均动脉压的缺点,具有一定优越性。     

布加氏综合征行转流术的麻醉处理体会

患者男,２９岁,因布加氏综合征而行肠系膜上静脉右颈内静脉人工血管转流术。麻醉依次静注安定１０ｍｇ、羟基丁酸钠２５ｇ、芬太尼０１ｍｇ、琥珀胆碱８０ｍｇ诱导,气管插管后静滴２％普鲁卡因复合液加间断芬太尼静注及吸入安氟醚维持。常规机械通气及监测ＢＰ、...     

七氟醚复合雷米芬太尼快通道麻醉在鼻内窥镜手术中的应用

目的观察七氟醚复合雷米芬太尼快通道麻醉在鼻内窥镜手术中的应用效果。方法 60例择期行鼻内窥镜手术患者,年龄21～55岁,随机分为三组,每组20例。Ⅰ组全凭吸入七氟醚麻醉,Ⅱ组丙泊酚复合雷米芬太尼,Ⅲ组七氟醚复合雷米芬太尼。观察三组患者术中、术后血流动力学变化,记录术后拔管时间、清醒时间、术后躁动评分(RS)、意识状态评分(OAA/S)等。结果三组术中血压控制均较满意。术后Ⅱ、Ⅲ组拔管时间及清醒时间较Ⅰ组短,躁动发生率稍低(P0.05)。结论七氟醚复合雷米芬太尼静吸复合麻醉与丙泊酚复合雷米芬太尼全凭静脉麻醉均为鼻内窥镜手术提供安全、快捷、苏醒彻底的快通道麻醉方法。     

七氟醚或氯胺酮麻醉诱导对法洛四联症患儿血流动力学的影响

目的采用压力记录分析法(PRAM)比较七氟醚或氯胺酮对法洛四联症患儿麻醉诱导期血流动力学的影响。方法选择拟在全麻下行法洛四联症矫治术的婴幼儿36例,年龄4~24个月,随机分为两组,每组18例。分别采用8mg/kg氯胺酮肌注(K组)和6%七氟醚吸入(S组)麻醉诱导,患儿意识消失后开放外周静脉并建立桡动脉监测,连接MostCare监测仪,采用PRAM监测血流动力学参数,依次静注咪达唑仑0.2mg/kg、哌库溴铵0.2mg/kg和舒芬太尼1μg/kg,气管插管后行机械通气。记录建立有创动脉测压后即刻(T_0)、静脉用药后1min(T_1)、2min(T_2)、5min(T_3)和气管插管后1 min(T_4)、2 min(T_5)、5 min(T_6)、10 min(T_7)的HR、SBP、DBP、心脏指数(CI)、每搏量指数(SVI)、体循环阻力指数(SVRI)和压力升支最大斜率(dp/dt),并计算心率-收缩压乘积(RPP)。结果与T_0时比较,T_1~T_7时两组HR明显减慢,RPP明显降低(P0.05);K组T_1~T_7时SBP、DBP、CI,T_1~T_4、T_6时SVI,T_2~T_7时SVRI和dp/dt明显降低(P0.05);S组T_4~T_7时SBP、T_7时DBP、T_4~T_7时CI、T_3~T_7时SVI明显升高(P0.05)。S组T_0、T_3~T_7时HR、RPP,T_0时DBP、CI,T_0、T_1时SBP和T_0~T_6时dp/dt明显低于K组(P0.05);S组T_7时DBP、CI,T_3~T_7时SVI均明显高于K组(P0.05)。结论与氯胺酮比较,七氟醚更有利于维持法洛四联症婴幼儿麻醉诱导期血流动力学稳定。     

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) response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with four concentrations of sevoflurane followed by nitrous oxide (N2O) 50% and sevoflurane in concentrations administered by clinical judgment. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. PATIENTS: 60 unpremedicated, ASA physical status I and II adult patients undergoing surgery with general anesthesia. INTERVENTIONS: After fentanyl 3 micrograms/kg, VCRII was accomplished with four concentrations of sevoflurane in O2: Group 1 (n = 15): sevoflurane 3%; Group 2 (n = 15): sevoflurane 4%; Group 3 (n = 15): sevoflurane 5%; and Group 4 (n = 15): sevoflurane 6%. At loss of consciousness, rocuronium 0.6 mg/kg was given, and intubation was performed 90 seconds later. Thereafter, anesthesia 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 after, tracheal intubation during a 5-minute period. The hemodynamic profile among groups was similar, with a slight hypertensive and tachycardic response to intubation. CONCLUSION: VCRII with sevoflurane 3% to 6% following fentanyl 3 micrograms/kg can be considered for blunting the hemodynamic response to tracheal intubation in healthy patients.     

不同剂量右美托咪定对丙泊酚诱导效应室靶浓度的影响

目的观察不同剂量右美托咪定在全麻患者气管插管时有效性和安全性及对丙泊酚效应室靶浓度(Ce)的影响。方法 60例全麻下行择期上腹部手术患者,随机均分为四组:D1、D2、D3、C组,分别在麻醉诱导前10min静脉泵注右美托咪定0.25μg/kg(D1组)、0.5μg/kg(D2组)和1.0μg/kg(D3组)及10ml生理盐水(C组)。麻醉诱导采用靶控输注丙泊酚,以BIS为靶控目标。丙泊酚初始Ce设为1.5μg/ml,递增梯度为0.5μg/ml,同时泵注瑞芬太尼0.2μg·kg-1·min-1。BIS≤60时推注罗库溴铵0.9mg/kg,BIS≤50并维持5s行气管插管。于输注右美托咪定前(T0)、诱导前(T1)、气管插管前(T2)、气管插管后1min(T3)、3min(T4)、5min(T5)、10min(T6)时记录SBP、DBP、HR、BIS、丙泊酚Ce。结果与T0时比较,T1时D2、D3组HR减慢、D3组SBP、DBP升高(P<0.05);与T1时比较,T2时D1组和C组SBP、DBP下降,HR减慢(P<0.05);与T2时比较,T3～T5时D1组和C组SBP、DBP升高,HR增快,T3时C组BIS升高(P<0.05)。T2～T6时丙泊酚CeD1、D2、D3组明显低于C组(P<0.05)。不同剂量右美托咪定各时点对丙泊酚Ce存在明显负相关关系。结论麻醉诱导前静脉输注不同剂量右美托咪定对丙泊酚诱导效应室浓度存在负相关关系。麻醉诱导前静脉输注右美托咪定0.5μg/kg心血管反应平稳并能显著减少诱导时所需丙泊酚Ce。     

七氟烷复合芬太尼用于成人麻醉诱导的临床研究

目的观察七氟烷在复合诱导时BIS（脑电双拼指数）与MAC（最低肺泡有效浓度）的相关性和血流动力学的变化。方法60例行全身麻醉的患者（ASA分级Ⅰ～Ⅱ）根据年龄的不同分为A、B两组。A组为≤40岁;B组为41～69岁。开始吸入诱导时氧流量为6L／min,体积分数为8％七氟烷,嘱病人深呼吸,意识丧失时给予维库溴胺0．1mg／kg,芬太尼2μg／kg,BIS值降至40～55之后氧流量减为每分钟4L／min,维持BIS在40-55,SBP在90-120mmHg范围内调节七氟烷的浓度,3分钟后行气管插管。记录并分析患者纂础值、意识丧失时、气管插管时、插管后1、3分钟的BIS、MAC、BP（血压）、HR（心率）。结果①两组患者意识丧失时和气管插管时年龄、BIS与MAC有相关性（P〈0．05）;②两组患者的BIS和BP、HR无明显相关性（P〉0．05）;③两组病人诱导时血流动力学稳定。结论七氟烷复合芬太尼诱导时患者BIS和MAC有相关性,BIS和BP、HR无明显相关性,诱导过程血流动力学比较平稳．可以用于成人。     

Gender may affect the hemodynamic response to induction and intubation in young adults

STUDY OBJECTIVES: To determine whether gender affects the hemodynamic response to anesthesia induction and intubation in young adults. DESIGN: Randomized clinical trial. SETTING: University hospital. PATIENTS: 83 healthy patients, aged 20 to 30 years, scheduled for orthopedic, plastic, and general surgery. INTERVENTIONS: Patients were randomly allocated to one of three groups: Anesthesia was induced with fentanyl 1.5 microg/kg and thiopental 3 mg/kg in Group 1 (n = 28, men) and Group 2 (n = 28, women), or fentanyl 1.5 microg/kg and thiopental 2 mg/kg in Group 3 (n= 27, women) and maintained with enflurane 1% in N2O-O2 throughout the observational period. Three minutes after induction, direct laryngoscopy and intubation were performed. MEASUREMENTS: Noninvasive systolic (SBP) and diastolic (DBP) blood pressures, and heart rate (HR) were recorded before induction (baseline), immediately before intubation, immediately after intubation, and then every 1 minute for 5 minutes after intubation. RESULTS: SBP, DBP, and HR did not differ between men and women at baseline. However, SBP and DBP were lower in women than in men (p < 0.05) and immediately before intubation and at overall time points after intubation. There were no significant differences noted in SBP, DBP, and HR between Groups 2 and 3. When compared with baseline values, SBP and DBP were decreased in women, whereas only DBP was decreased in men immediately before intubation (p < 0.05). The increase in SBP was more prolonged in men after intubation. CONCLUSIONS: Pressor response is different in women than men, suggesting the difference of the response might result from the gender differences.     

妇科腹腔镜手术全凭静脉麻醉与异氟醚吸入麻醉的对比研究

目的观察瑞芬太尼靶控输注复合异丙酚全凭静脉麻醉与异氟醚吸入麻醉在妇科腹腔镜手术中的应用效果。方法随意选择2008年1～12月择期妇科腹腔镜手术60例,ASA分级Ⅰ～Ⅱ级,分为2组：靶控输注瑞芬太尼复合异丙酚全凭静脉麻醉组（T组,n=30）,采用咪唑安定0.05 mg/kg,瑞芬太尼1μg/kg,异丙酚2～2.5 mg/kg及维库溴铵0.1 mg/kg快速诱导后,经口明视气管插管,维持采用瑞芬太尼靶浓度4～8 ng/ml,异丙酚4～8 mg.kg-1.h-1;异氟醚组（I组,n=30）,采用芬太尼2μg/kg,异丙酚2～2.5 mg/kg,维库溴铵0.1 mg/kg诱导,经口明视插管后,维持采用1∶1的氧气和异氟醚（维持呼气末浓度0.8～1.2 MAC）吸入麻醉。术中监测收缩压（SBP）、舒张压（DBP）、心率（HR）等指标。结果在插管后1 min（T3）,I组病人DBP、HR与基础值（T1）比较明显升高（P〈0.05）,T组病人DBP、HR则基本恢复到T1水平,2组比较差异有显著性（t=-4.277,P=0.000;t=-3.286,P=0.002）。清醒拔管时（T6）与T1比较,I组SBP、DBP、HR明显升高（P〈0.05）,而T组SBP、DBP、HR则无明显变化（P〉0.05）,2组比较差异有显著性（t=-5.461,P=0.000;t=-2.287,P=0.000;t=-4.382,P=0.000）。T组病人诱导时间、苏醒时间、拔管时间均显著短于I组（t=-6.386,P=0.000;t=-4.876,P=0.000;t=-6.632,P=0.000）。结论瑞芬太尼靶控输注复合异丙酚全凭静脉麻醉在妇科腹腔镜手术中既满足了手术要求又提高了麻醉药的可控性。     

喉罩与气管插管在全麻或复合硬膜外阻滞时的心率和血压改变

目的比较喉罩与气管插管用于全麻或全麻复合硬膜外阻滞患者的HR和BP变化.方法妇科手术80例,随机分为全麻气管插管(T)组、全麻喉罩(L)组、硬膜外阻滞 全麻气管插管(ET)组、硬膜外阻滞 全麻喉罩(EL)组,每组20例.硬膜外阻滞用1%利多卡因 0.15%丁卡因.全麻诱导咪唑安定2 mg、芬太尼0.2 mg、丙泊酚1.5 mg/kg、琥珀胆碱1.5 mg/kg后插气管导管或喉罩.全麻维持50%N2O O2 异氟醚,静注阿曲库铵、芬太尼.于麻醉前(基础,入室静卧10 min后)、插管后1 min、切皮、进腹探查后5 min、拔管后1 min记录MAP、SpO2、HR、PETCO2.结果插管时HR和MAP均低于基础值,而两组喉罩HR低于插气管导管者,硬膜外复合全麻喉罩组MAP低于气管插管组.切皮时两组全麻MAP高于复合硬膜外组.探查时两组复合硬膜外者HR和MAP均低于基础值,且MAP低于单纯全麻者(P＜0.05).拔管时各组HR均显著高于基础值,MAP未复合硬膜外者显著高于基础值.结论(1)插喉罩对BP和HR的影响不如气管导管剧烈;(2)复合硬膜外阻滞时气管插管或喉罩置入应激反应轻,也可减轻探查时的BP波动.     

Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation

Study ObjectiveTo evaluate the effect of dexmedetomidine combined with fentanyl on hemodynamics.DesignProspective, double-blinded, randomized study.SettingOperating room of a university hospital.Patients30 ASA physical status II and III patients with mild-to-moderate cardiovascular disease.InterventionsPatients were assigned to one of three groups: Group D-F2 [dexmedetomidine, effect-site concentration (ESC) of fentanyl = two ng/mL]; Group F2 (placebo, ESC of fentanyl = two ng/mL), or Group F4 (placebo, ESC of fentanyl = 4 ng/mL).MeasurementsDexmedetomidine (an initial dose of 1.0 μg/kg for 10 min, followed by a continuous infusion of 0.7 μg·kg^–1·hr^–1) or placebo saline was administered 15 minutes before anesthetic induction. Anesthesia was induced with propofol and fentanyl using a target-controlled infusion system. Hemodynamic parameters: systolic (SBP) and diastolic blood pressures (DBP), and heart rate (HR) during anesthetic induction were measured and the percent changes were calculated for both induction and intubation.Main ResultsAfter inducing anesthesia, SBP was significantly higher in Group D-F2 (127 ± 24 mmHg) than Group F2 (90 ± 20 mmHg) or Group F4 (77 ± 21 mmHg). The SBP in Groups F2 and F4 reached 160 ± 31 mmHg and 123 ± 36 mmHg, respectively, after intubation, but no significant change in SBP was noted in Group D-F2. The percent increase in SBP due to tracheal intubation in Group D-F2 was 3% ± 4% and was significantly lower than that of Group F2 (70% ± 34%) or Group F4 (45% ± 36%).ConclusionDexmedetomidine combined with fentanyl during anesthetic induction suppresses the decrease in blood pressure due to anesthetic induction and also blunts the cardiovascular response to tracheal intubation.     

七氟醚吸入麻醉与丙泊酚静脉麻醉在超声引导下经皮微波消融治疗肝癌中的应用

目的 比较七氟醚吸入麻醉和丙泊酚静脉麻醉在超声引导下经皮微波消融疗法（PMCT）治疗肝癌中应用的优缺点。方法 选取40例原发肝癌患者，随机均分为七氟醚吸入麻醉组（S组）和丙泊酚静脉麻醉组（P组）。观察两组的诱导时间、苏醒时间、术中BP、HR和SpO2的变化，以及术中和术后并发症的发生情况。结果 两组诱导时间和苏醒时间之间的差异无统计学意义。P组治疗前后SBP、DBP和SpO2波动大于S组（P〈0．05）；S组恶心、呕吐的发生率较高，而P组注射痛和呼吸暂停的发生率高（P〈0．05）。结论 两种麻醉方法均能满足PMCT治疗肝癌的要求，七氟醚麻醉对呼吸、循环影响更小，但恶心、呕吐的发生率较高。     

The use of esmolol, nicardipine, or their combination to blunt hemodynamic changes after laryngoscopy and tracheal intubation

Laryngoscopy and tracheal intubation (LTI) often provoke an undesirable increase in blood pressure (BP) and/or heart rate (HR). We tested the premise that nicardipine (NIC) and esmolol (ESM) in combination (COMB) would oppose both. Adult surgical patients received pretreatment (randomized) with IV bolus NIC 30 microg/kg (n = 31), ESM 1.0 mg/kg (n = 34), or COMB (one-half dose each, n = 32). Peak BP and HR after LTI were compared with controls (CONT; n = 35) with no pretreatment. Anesthetic induction was standardized: IV thiopental (5-7 mg/kg), fentanyl (1-2 microg/kg), and succinylcholine (1.5 mg/kg). Systolic (S), diastolic (D), and mean (M) BP and HR awake before pretreatment (baseline) were similar in all test groups. No patient was treated for hypotension, bradycardia, or tachycardia after pretreatment or anesthetic induction. Peak HR after LTI was increased versus baseline in CONT and all test groups, but did not differ from CONT among the test groups. Peak SBP and DBP increased versus baseline in CONT, and with ESM and NIC, but not COMB. Peak SBP, DBP, and MBP were increased with ESM versus COMB, and peak DBP with ESM versus NIC. Compared with no pretreatment before the IV induction of general anesthesia, the peak increase in BP after LTI is best blunted by the combination of nicardipine and ESM, compared with either drug alone. No single drug or combination in the doses tested opposed increased HR. IMPLICATIONS: Compared with no pretreatment before the IV induction of general anesthesia, the peak increase in blood pressure after laryngoscopy and tracheal intubation is best blunted by the combination of nicardipine and esmolol, compared with either drug alone. No single drug or combination in the doses tested opposed increased heart rate.