Attenuating the Haemodynamic Stress To Laryngoscopy And Intubation With I.V. Magnesium Sulphate And LignocaineComparative Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Direct laryngoscopy and endotracheal intubation frequently induces a cardiovascular stress response characterized by hypertension and tachycardia due to reflex sympathetic simulation. The response is transient occurring 30 seconds after intubation and lasting for less than 10 minutes2 .Although the haemodynamic stress response is transient, and of little consequence in healthy individuals, it is hazardous to those with systemic hypertension, coronary artery disease, and cerebro vascular disease. Complications like myocardial ischaemia, infarction, left ventricular failure, arrhythmias, intracranial hemorrhage can occur due to this response.The major cause of the haemodynamic stress response is due to the stimulation of supraglottic area by the laryngoscope blade followed by additional stimulation contributed by tracheal tube placement.Till date the mainstay of attenuation of the haemodynamic stress response was done by using various drugs like local anesthetics, beta-blockers, calcium channel blockers, opiods and vasodilators.3,4 All of these techniques which are suggested have some disadvantages related to either cardiovascular or respiratory depression, but none of them directly inhibits the release of catecholamines. Magnesium sulphate blocks the release of catecholamines from the adrenergic nerve terminals and adrenal glands. In our study, which was carried out in the Department of Anaesthesiology at Narayana medical college hospital we compared intravenous Magnesium sulphate and Lignocaine in attenuating the haemodynamic stress response (increase in heart rate and an increase in the mean arterial pressure) to laryngoscopy and intubation.
Authors and Affiliations
Dr. Raviteja Vallabha, Dr. Vijaya Kumar Muthayala
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