COMPARISON OF HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND INTUBATION WITH PROPOFOL AND PROPOFOL PLUS INTRAVENOUS LIGNOCAINE IN KNOWN HYPERTENSIVE PATIENTS
Abstract
ABSTRACT
INTRODUCTION: Endotracheal intubation is a stressful stimulus, which is responsible for the complications mostly in patient with high BP and cardiovascular diseases. Propofol is an ideal intravenous (I.V) anesthetic agent that decreases cardiovascular response to laryngoscopy and endotracheal intubation. However mere use of Propofol has not shown complete satisfactory results and a need of further attenuation is felt. Various studies have been conducted on Lignocaine to check its effects on hemodynamic response to intubation. Aim of this study was to see effects of Lignocaine on cardiovascular response to intubation, when used as adjunct to Propofol.
Objective: To evaluate the attenuation of hemodynamic response to laryngoscopy and intubation in response to I.V lignocaine in known hypertensive patients.
Material and Methods: Following Institutional Review Board approval, data of 60 patients who went under general anesthesia was collected. Patients with ASA (American Society of Anesthesiologist) physical status grade II and III (known hypertensive) belonging to any gender ranging from 30 to 65 years of age were included. These Patients were randomly divided into two groups, group P and group PL. Patients in group P received injection of propofol with a dosage of 2mg/kg and group PL patients received injection of lignocaine 1.5mg/kg in addition to propofol dosed at 2mg/kg. Hemodynamic indicators (HR, SBP and DBP) were noted down before induction, three minutes before intubation, thirty seconds and 5 minutes after intubation followed by statistical analysis performed on the obtained data.
Results: A significant increase in haemodynamic response (Increased HR, SBP, DBP and MAP) was seen after the insertion of ETT in group P. On the contrary, response to intubation was less significant, in fact quite diminished in group PL. It was also observed that the haemodynamic response to ETT insertion is significantly greater than that to laryngoscopy alone.
Conclusion: Lidocaine is an effective medication to minimize hemodynamic responses (HR, SBP and DBP) in patients undergoing intubation for general Anesthesia.
KEYWORDS: Hemodynamic response, Laryngoscopy, Intubation, Propofol, Propofol plus, Intravenous lignocaine, Hypertensive patients
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