Alterations in Hemodynamic Response to Laryngoscopy and Intubation by Lidocaine, Esmolol, and Nitroglycerin-A comparative study
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 10
Abstract
Background: The pressure response to laryngoscopy and endotracheal intubation has been recognized since long, resulting a rise in pulse and blood pressure. Aims and Objectives: To compare the safety and efficacy of standard IV bolus doses of lidocaine, esmolol, and nitroglycerin in modifying the acute hemodynamic response to laryngoscopy and tracheal intubation. Materials and Methods: The study sample of 60 normotensive patients were categorized in to 4 groups. Group 1 = saline 5 ml IV at time 0 minutes; Group 2 = lidocaine 1.5 mgikg IV at time 1 minute; Group 3 = esmolol 1.4 mglkg IV at time 2 minutes and Group 4 = nitroglycerin 2 µg/kg IV at time 3 minutes. The parameters measured were Mean arterial pressure and Heart Rate. Results: MAP increased significantly following tracheal intubation in all four groups (control 47%±20%, lidocaine 53% ± 27%, esmolol 24%±12%, nitroglycerin 43% ±22%) compared with preinduction baseline values. in the esmolol group, the increase in HR was significantly lower than in the other three groups. Conclusion: Esmolol was significantly more effective than either lidocaine or nitroglycerin in controlling the increase in HR, and in minimizing the increase in MAP following tracheal intubation.
Authors and Affiliations
Dr Ramesh Pendela
Keywords
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