Anestesia e Pesquisa Clínica
Acesso livre

Abstrato

Effects of Combined Oral Contraceptive on Hemodynamic Response to Endotracheal Intubation

Ahmed Said Elgebaly, Rabab Mohamed Mohamed Mohamed

Background: The modern day anesthesiologist should demonstrate and understand a fluctuation in a women’s perception of pain in relation to phase of menstrual cycle. Combined oral contraceptive is used to prevent pregnancy, it contains a small amount of 2 female sex hormones, drospirenone, has an effect similar to the natural corpus luteum and ethinylestradiol, a hormone with an estrogenic effect. Pain threshold during follicular phase is higher than later phases and this may affect various anesthetic techniques.
Objectives: The present study was designed to evaluate the effects of contraceptive pills on hemodynamic response to endotracheal intubation.
Methods: We enrolled, 600 female patients scheduled for elective surgery divided to (Group І; n=300) with a history of family planning by combined oral contraceptive pills contain drospirenone 3 mg and ethinylestradiol 30 μ for at least one month. (Group ІІ; n=300) with regular menstrual cycle on 8-12 days after the 1st day of the last menstrual cycle. Mean arterial blood pressure and heart rate was recorded for all patients, just before endotracheal intubation, 1, 2, 3 and 5 min after intubation. Epinephrine and norepinephrine as stress hormones in the blood were measured before induction of anesthesia and immediately after intubation.
Results: The study as regard MABP showed that, there was significant difference between groups before intubation, in one and two min after intubation. Meanwhile, MABP measured at 3 and 5 min after intubation showed no significant difference between both groups. While HR showed significant difference between both groups only at one and two min after intubation There was insignificant increase in group I when compared with group II in level of epinephrine in the blood before induction and significant increase in group I when compared with group II in norepinephrine in the same period. While immediately after intubation there was significant increase in group I when compared with group II in level of both epinephrine and norepinephrine. Also, there was significant increase in group I and group II immediately after intubation when compared with pre-induction value.
Conclusion: Pretreatment with combined oral contraceptives increases the pressor response to laryngoscopy and the intubation of the trachea.