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PAFMJ-Pakistan Armed Forces Medical Journal. 2016; 66 (4): 520-524
in English | IMEMR | ID: emr-182553

ABSTRACT

Objective: To evaluate the efficacy of plain lignocain in attenuation of stress response to laryngoscopy and endotracheal intubation with impact on in-hospital mortality or morbidity


Study Design: A randomized control trial


Place and Duration of Study: Our study was carried out from December 2013-14, at tertiary-care hospital


Material and Methods: Patients [n=100 total] were randomized, using non-probability convenient sampling, dividing the population in two groups. Group A [n=50] as control, and in group B [n=50] Injection lignocain plain 2% 1.5 mg/kg was used 3 minutes prior to intubation. Both the groups were observed for changes in hemodynamic parameters i.e. heart rate [HR] systolic and diastolic blood pressure, Mean Arterial Pressure for every minute after baseline [0] and for 5 consecutive minutes [1, 2, 3, 4, and 5]. Deviation of >20% from baseline was considered significant. The mortality [death within hospital, irrespective of cause] and morbidity [defined as emergence of 4 condition as hypertensive encephalopathy, Acute Coronary Syndrome, Lab proven Myocardial Infarction and negative pulmonary edema] within 10 days of hospitalization were noted


Results: Statistically significant [p-value extremely significant at confidence interval of 98 degrees] results were obtained in the effect of study drug; however, 10 days of hospitalization remained inconclusive for emerging morbidity categories strictly due to the intubation reflexes. We consider few technicalities in peri-operative management resulted in such events


Conclusion: Lignocain is effective in blunting the pressor response towards laryngoscopy and intubation. However the impact on mortality/ morbidity for four conditions remained inconclusive

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