Laryngoscopy and tracheal intubation often induced an undesirable increase in blood pressure and heart rate. We evaluated the preventing effect of nicardipine infusion on the increase of the blood pressure (BP) and heart rate (HR) following a direct laryngoscopy and tracheal intubation.

Sixty, ASA physical status 1-2, adult patients were selected with informed consent, and randomly allocated into two groups; control group (n = 30) and nicardipine group (n = 30). In the control group, 1.8 ml/kg/h of normal saline was infused, and in the nicardipine group, 5 µg/kg/min of nicardipine was infused continuously from 2 minutes before intubation to 3 minutes after intubation. BP and HR were measured by non-invasive method after arrival at the operating room, before tracheal intubation, shortly after tracheal intubation, and 1, 3, 5, and 10 minutes following intubation. Data were analyzed by repeated measure of ANOVA and t-test.

Systolic and diastolic BP were significantly lower in the nicardipine group than in the control group (P < 0.05). HR showed significantly higher value in the nicardipine group (P < 0.05).

The continuous infusion of nicardipine (5 µg/kg/min) was effectively attenuating an increase of BP during tracheal intubation. But the increase in HR is not blunted by nicardipine infusion and there is a significant increase in HR. Although rate-pressure product (RPP) does not increase, the use of nicardipine for blunting hemodynamic responses should be considered carefully in patients with ischemic heart disease.