ABSTRACT
Not many studies have compared more than two drugs in attenuating pressor responses to laryngoscopy and intubation. This study compares four groups of considerable size. The present study compared intravenous esmolol, diltiazem, and lignocaine, for their efficacy to abate pressure response to laryngoscopy and intubation. METHODSThis is a prospective, randomized, double-blinded, controlled clinical study conducted among 220 patients of ASA grade I/II (age 18–60 years), undergoing elective surgical procedure requiring general anaesthesia with endotracheal intubation over a period of 15 months at a tertiary hospital setup. Study subjects were categorised as Groups D, E, L, and N that received diltiazem (0.2 mg/Kg IV), esmolol (2 mg/Kg IV), lignocaine (1.5 mg/Kg IV), and normal saline, respectively; each group had 55 patients. Haemodynamic parameters were recorded at baseline, after drug administration, immediately after intubation, and at 1-, 3-, and 5-minutes after intubation. Data entry and analysis were performed using MS Excel and SPSS-PC-17 version, respectively. One-way ANOVA and the chi-square test were used to evaluate the difference. P < 0.05 was considered significant. RESULTSA maximum increase in haemodynamic parameters occurred immediately after intubation. The increase in heart rate and rate pressure product were significantly lower in Group E (+2.93% & +15.31%), whereas the increase in blood pressure was lower in Group D (8.51%). CONCLUSIONSHaemodynamic stability during laryngoscopy and endotracheal intubation is an integral and essential goal of any anaesthetic management plan and was more effectively maintained with esmolol and diltiazem than with lignocaine.
ABSTRACT
Introduction: Alpha-2 (α2) adrenergic receptor agonists,clonidine and dexmedetomidine, are widely used as adjuvantsduring anesthesia for analgesic, sedative, sympatholytic, andcardiovascular stabilizing effects. The aim of this study was todifferentiate the effectiveness of intravenously administeredclonidine and dexmedetomidine for hemodynamic stabilityand postoperative analgesia during laparoscopic surgery.Materials and methods: This was a randomised, double blindand prospective study in which Group 1 included patients whoreceived 2 µg/kg of clonidine dilute in 10 ml normal saline,given slow intravenous infusion over 10 minutes beforeinduction of general anaesthesia. Group 2 patients received 1µg/kg of dexmedetomidine diluted in 10 ml of normal saline,given slowly intravenous infusion over 10 minutes beforeinduction of general anaesthesia.Results: The data was presented as Mean ± SD. Groups werecompared by independent student’s t test. Groups were alsocompared by repeated measure analysis of variance (ANOVA)using general linear models (GLM). The mean scores of SBPwere higher in group 1 among both the groups over the periods.The mean scores of DBP in both groups was similar over theperiods with slightly being higher in Group 1 especially after30 min to till end (Extubation) as compared to Group 2.Conclusion: It can be concluded that α 2 agonists were foundto be effective in attenuating the hemodynamic responseto pneumoperitoneum during laparoscopic surgeries andprovides reliable postoperative analgesia and sedation whenused as a premedication agent