Comparing the Effect of Labetalol versus Morphine on Controlling Blood Pressure and Pulse Rate During Emergence from Anesthesia after Craniotomy

Document Type : Original Article

Authors

Department of Anesthesiology, School of Medicine, Anesthesia and Critical Care Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Emergence from anesthesia is associated with sympathetic stimulation, increase in pulse and blood pressure. There are different methods, but the most appropriate method should be selected regarding the differences in nationalities. This study aimed to compare the efficacy of morphine and labetalol in controlling blood pressure and pulse during emergence from anesthesia in brain tumors craniotomy. Materials and Methods: This study was conducted at Al-Zahra Hospital of Isfahan - Iran on 60 patients suffering from brain tumor candidated for craniotomy and randomly classified into two groups of 30. One group received labetalol with dose of 10 mg over 10 min from 45 min before finishing dressing and then 0.75 mg/min until 35 min later; another group received morphine in bolus dose of 0.1 mg/kg during 2–3 min. Blood pressure and pulse were measured every 10 min over 40 min. After operation, they were measured every 5 min over 15 min. Results: The morphine group had higher systolic (133.3 ± 18.8) and diastolic blood pressure (87.1 ± 13.6) (P = 0.021 and 0.028, respectively) at extubation and during 45 min before dressing, the diastolic blood pressure was significantly higher in compares with labetalol (75.3 ± 10.5) (P < 0.05). And extubation time was significantly shorter in labetalol group (7.7 ± 0.84) (P < 0.001). Pulse had no significant difference in both groups. In labetalol group, blood pressure and pulse fluctuations were more stable. Conclusion: Administration of labetalol 45 min before finishing dressing can significantly control blood pressure during emergence from anesthesia and also shorten the time of extubation during emergence in patients undergoing craniotomy.

Keywords

1.
Grubb T. Anesthetic Complications and Emergencies and How to Handle Them (Proceedings); 2010. Available from: http://www.veterinarycalendar.dvm360.com/avhc/Medicine/Anesthetic-complications-and-emergencies-and-how-t/ArticleStandard/Article/detail/737235. [Last cited on 2014 Aug 01].  Back to cited text no. 1
    
2.
Hartley M, Vaughan RS. Problems associated with tracheal extubation. Br J Anaesth 1993;71:].  Back to cited text no. 2
[PUBMED]    
3.
Kross RA, Ferri E, Leung D, Pratila M, Broad C, Veronesi M, et al. Acomparative study between a calcium channel blocker (Nicardipine) and a combined alpha-beta-blocker (Labetalol) for the control of emergence hypertension during craniotomy for tumor surgery. Anesth Analg 2000;91:].  Back to cited text no. 3
[PUBMED]    
4.
Goma HM, Ali MZ. Control of emergence hypertension after craniotomy for brain tumor surgery. Neurosciences (Riyadh) 2009;14:167-71.  Back to cited text no. 4
[PUBMED]    
5.
Cottrell JE, Young WL. Cottrell and Young's Neuroanesthesia. 5th ed. Philadelphia, USA: Elsevier Health Sciences; 2010.  Back to cited text no. 5
    
6.
Do HS, Kim SY, Heo SJ, Park SJ. The effect of intravenous labetalol administration on hemodynamic responses during desflurane inhalation. Korean J Anesthesiol 2012;62:245-50.  Back to cited text no. 6
[PUBMED]    
7.
Owens WB. Blood pressure control in acute cerebrovascular disease. J Clin Hypertens (Greenwich) 2011;13:205-11.  Back to cited text no. 7
[PUBMED]