A prospective study on role of melatonin inattenuation of haemodynamic responses to laryngoscopyintubation and extubation
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 8, Issue 2
Abstract
Background:Endotracheal intubation is translaryngeal placement of Endotracheal tube into the trachea. Laryngoscopy and tracheal intubation are commonly accompanied by increasing arterial BP and HR. Complications that might arise are acute LVF, dysrhythmias, IC haemorrhage, pulmonary oedema, or MI. Pressor response is exaggerated in hypertensive patients even though rendered normotensive preoperatively by anti hypertensive medication.Aims: Aim of the study is to compare the effect of Melatonin with Placebo in attenuating Haemodynamic responses during laryngoscopy and endotracheal intubation.It also aims to observe whether melatonin helps in maintaining stable hemodynamicsintraoperatively and in attenuating extubation response.Materials and methods: It is a prospective randomized control study conducted in Osmania general hospital and in Govt. ENT hospital from Nov2016 to Nov2017.The study was conducted on 60 patients.They were divided into two groups.Group M, who received capsule melatonin 6 mg, Group C who received placebo (Vitamin D3) 120 minutes before surgery. Results: The increase in HR during laryngoscopy and intubation was significantly less in melatonin group compared to control. (P0.0029). Variation in heart rate during extubation, and post extubation was also very significantly less in melatonin group than placebo. Systolic BP was significantly less in melatonin group after the induction, during laryngoscopy and intubation and all the time during post intubation period till 10 minutes. Intraoperatively, systolic BP was significantly less in melatonin group. There was extremely significant decrease in SBP in melatonin group during extubation and post extubation period compared to placebo. Diastolic BP was less in melatonin group compared to placebo during laryngoscopy and intubation and at 1 minute, 5 minutes and at 10 minutes after intubation. Intraop DBP was significantly less in melatonin group. During extubation and post extubation period, also DBP was significantly less in melatonin group. MAP during intraoperative period was also significantly less in melatonin group. During extubation, and post extubation period, there was an extremely significant difference in both the groups.Conclusion: The study concludes that exogenously administered melatonin 6mg orally 120mnts prior to intubation helps in attenuation of haemodynamic responses to laryngoscopy,intubation and extubation.It also helps in maintaining a stable hemodynamicsintraoperatively.
Authors and Affiliations
Adithi Devi E, WR PathanjaliRao, Pavani Kalyanam
Keywords
Related Articles
- EP ID EP449575
- DOI 10.26611/1015824
- Views 166
- Downloads 0
Comparison of Propofol and Thiopentone as anaesthetic agents for electroconvulsive therapy - A prospective, double blinded cross over trial
Background: The ideal anaesthetic agent for electroconvulsive therapy (ECT) should provide a smooth, rapid induction and recovery with minimal antagonistic effect on the seizure activity. We compared two induction agents...
Diagnostic value of different screening tests for predicting difficult intubation
Aims: The aim of current study was to compare the diagnostic value of different screening test in predicting difficult intubation. Settings and Design: Hospital based observational cross sectional study Methods and Mater...
A study to compare the effects of single dose intravenous dexmedetomidine and clonidine on bupivacaine spinal anaesthesia
Background: Dexmedetomidine, also an α2-adrenergic agonist, used for pre-medication and as additive to general anesthesia. Dexmedetomidine when given intravenously decreases the inhalational anesthetic and opioid require...
Incidence of complications after prophylactic phenylephrine and placebo in elective urological surgeries
Background: Spinal anesthesia is commonly practiced neuraxial anesthesia for various surgeries including gynecological, obstetrics, urological, orthopedics, etc. The most common impediments to the effective use of neurax...
Comparative study on efficacy of caudal bupivacaine and ropivacaine in providing postoperative pain relief in children
Background: Pain is an unpleasant subjective sensation which can only be experienced and not expressed, especially in children. Pain relief is even more important in children who rely on their parents or caregivers for t...