18Jun 2017

ATTENUATION OF CARDIOVASCULAR RESPONSE DURING DIRECT LARYNGOSCOPY AND INTUBATION: A COMPARATIVE STUDY BETWEEN FENTANYL, LIGNOCAINE AND PLACEBO DURING GENERAL ANAESTHESIA

  • Assistant Professor, Department Of Anaesthesiology, Maheshwara Medical College And Hospital, Patancheru, Sangareddy, Telangana.
  • Senior Resident, Department Of Anaesthesiology, Gandhi Medical College, Hyderabad, Telangana.
Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Aims and Objectives: The aim of this study was to compare Fentanyl, Lignocaine and Placebo for attenuation of cardiovascular response to direct laryngoscopy and intubation during General Anaesthesia. Methodology: After obtaining ethical committee approval and taking written informed consent from patients this study was done at Maheshwara medical college & hospital in 75 patients of ASA grade I aged between 25-45 years coming for elective surgical procedures. The patients were allocated into three groups of 25 each: Group F ? Fentanyl 2 g/kg body weight Group L - Lignocaine 1.5 mg/kg body weight Group N - Normal saline 3 ml as placebo Observation and Results: The heart rate, systolic and diastolic blood pressure responses during laryngoscopy and intubation have shown significant difference with fentanyl and lignocaine when compared with the placebo group. Conclusion: This study confirms that Fentanyl attenuates both heart rate and blood pressure responses to laryngoscopy and intubation, whereas with Lignocaine blood pressure was effectively controlled than heart rate.

  1. Reid LC, Brace DE. Irritation of the respiratory tract and its reflex effect upon heart.?Surg Gynaec & Obst.?1940; 70:157?62.
  2. Gupta S, Tank P. A comparative study of efficacy of esmolol and fentanyl for pressure attenuation during laryngoscopy and endotracheal intubation.?Saudi J Anaesth.?2011; 5 (1):2?8.?Jan-Mar.
  3. Stoelting RK. Circulatory changes during laryngoscopy and tracheal intubation: Influence of duration of laryngoscopy with or without prior lidocaine.?Anaesthesiology.?1977; 47:381?3.
  4. Scheinin B, Scheinin M, Vuorinen J, Lindgren L. Alfentanil obtund the cardiovascular and sympathoadrenal responses to suxamethonium facilitated laryngoscopy and intubation.?Br Jr Anesth.1989; 62:385?92.
  5. Gopinath R, Thota S. Nifedipine to attenuate cardiovascular responses to endotracheal intubation.?J Anaesth Clin Pharmacology.?1989; 5:99.
  6. Stoelting RK. Attenuation of blood pressure to laryngoscopy and tracheal intubation with sodium nitroprusside.?Anaesth Anal.?1979; 58:116.
  7. Davidson JA, Gilliespsie JA. Tracheal intubataion after induction of anesthesia with propofol, Alfentanil and i.v. lignocaine.?Br J Anaesth.?1993; 70:163?6.
  8. Davis MJ, Cronin KD, Cowie RW. The prevention of hypertension at intubation: a controlled study of intravenous hydralazine on patients undergoing intracranial surgery.?Anaesthesia.?1981; 36:147.
  9. Stoelting RK. Blood pressure and heart rate changes during short duration laryngoscopy for tracheal intubation: Influence of viscous or i.v. lidocaine.?Anaesth Analg.?1978; 57:197?9.
  10. Bachofen M. Suppression of blood pressure increases during intubation: Lidocaine or fentanyl? Anesthetist.?1988; 37(3):156?61.
  11. Butterworth JF, Struchartz GR. Molecular mechanisms of local anesthesia: a review.?Anesthesiology.1990; 72:711?734.
  12. Collins VJ. 3rd Edn. Philadelphia: Lea and Febiger; 1993. Principles of anesthesiology, general and regional anesthesia. Vol.I and II.
  13. King B.D., Harris L.C., Greifenstein F .E., Elder J.D., and Dripps R.D., Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anaesthesia; Anaesthesiology: 1951: 12:556-66.
  14. Dahlgren N., and Messeter K., Treatment of stress response to laryngoscopy an intubation with fentanyl: Anaesthesia: 1981:36:1022-26.l
  15. Flacke JW, David U, Flacke WE et al: Effects of fentanyl and diazepam in dogs deprived of autonomic tone. Anesth Analg 64-1053, 1985
  16. Helfmann, Steven, Gold, Martin: Which drug prevents tachycardia & hypertension associated with tracheal intubation? (Placebo, lidocaine, Fentanyl, Esmolol): Anaesthesia, Analgesia Apr-91, Vol: 72, No: 4.
  17. K, Sinatra, Raymond S, Halevy: Comparative study-ability of a combination of Fentanyl & Esmolol to blunt the hemodynamic effects of intubation with that of either agent alone. Oct -92, Vol: 39, No: 8.
  18. J E. Smith, M.J.King, H.F. Yanni, K.A. Pottinger effects of fentanyl on the circulatory responses to orotracheal, fibreoptic intubation: Anaesthesia -92.

[Jyothsna Yadav .C, Abhishek Vuppala and Roopa Kotha. (2017); ATTENUATION OF CARDIOVASCULAR RESPONSE DURING DIRECT LARYNGOSCOPY AND INTUBATION: A COMPARATIVE STUDY BETWEEN FENTANYL, LIGNOCAINE AND PLACEBO DURING GENERAL ANAESTHESIA Int. J. of Adv. Res. 5 (Jun). 918-924] (ISSN 2320-5407). www.journalijar.com

DR.JYOTHSNA YADAV.C
Maheshwara Medical College And Hospital

DOI:

Article DOI: 10.21474/IJAR01/4494      
DOI URL: https://dx.doi.org/10.21474/IJAR01/4494

Download Full Paper

Download PDF No. of Downloads: 22 | No. of Views: 99