Effects of lidocaine, fentanyl and esmolol on haemodynamics and bispectral index when used before laryngoscopy and intubation to prevent stress response in patients with etomidate induction
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 9
Abstract
Endotracheal intubation creates a period of hemodynamic instability in normotensive patients. Endotracheal intubation produces stimulation of laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines leading to hypertensive crisis. The objective of study is to evaluate and compare the efficacy of fentanyl, lidocaine and esmolol in attenuating the stress responses to laryngoscopy and endotracheal intubation in normotensive patients with etomidate induction. We conducted a prospective, randomized, double-blind study in 120 patients posted for laparoscopic surgery. All patients were randomly divided into four groups. The fentanyl group received Fentanyl 2 mcg/kg and lidocaine group received 2mg/kg lidocaine and esmolol group received 1mg/kg esmolol 3 min prior to intubation. BIS and hemodynamic parameters were recorded at baseline, after giving induction agents, and 1 to 5 minutes at each 1 min interval after endotracheal intubation. There were no significant differences between the three groups regarding hemodynamic parameters like heart rate, systolic diastolic and mean arterial blood pressure, but BIS value was better in fentanyl group. Esmolol, lidocaine and fentanyl effectively decreased the stress response to endotracheal intubation. But BIS was better in fentanyl group. Keywords: Fentanyl, Hemodynamic stress, Intubation, Lidocaine, clonidine.
Authors and Affiliations
Dr. Sidharth Sraban Routray, Dr Ranjeeta Mohapatra, Dr. Debasis Mishra, Dr. Avijit Swain
Keywords
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