Effects of prior [lidocaine - morphine] adminstration on cardiov ascular response to tracheal intubation

This study was carried out on 30 adult patients classified into three groups, ten patients each. Ten minutes preinduction, they were transtracheally injected with either normal saline, lidocaine 40 mg or a mixture of lidocaine [40 mg] with morphine 1 mg in a volume of 2.5 ml. Heart rate, systolic, diastolic and mean arterial blood pressure were monitored ten minutes before induction and every two minutes for 20 minutes after intubation. There was a significant reduction in heart rate, systolic, diastolic and mean blood pressure in lidocaine group and lidocaine-morphine group compared with the saline group. Also, it was found that heart rate and systolic blood pressure were significantly decreased in both lidocaine and lidocaine- morphine groups compared with the preinduction values

Intraperitoneal lidocaine for pain ralief during and after tubal sterilization

We conducted a randomized, blinded, placebo-controlled study to evaluate the effectiveness of intraperitoneal lidocaine, IM meperidine, or both drugs together for pain relief [intraoperative and postoperative] in postpartum tubal ligation. Sixty postpartum patients scheduled to have tubal ligation were randomly divided into four groups to receive IM isotonic sodium chloride solution [2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group I]; IM meperidine [100 mg in 2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group II]; IM injection of isotonic sodium chloride solution and intraperitoneal instillation of 1% lidocaine in 40 mL [Group III] and both imeperidine and intraperitoneal lidocaine instillation [Group IV]. The rninilaparotomy was performed after local infiltration with 20 ml of lidocaine. A numerical rating score was used to rate pain on a 0 - 10 scale during and after the surgical procedures. During the surgical procedures, the mean pain scores were 1.8 in group III and 0.7 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.4 and 6.0, respectively [p < 0.001]. Postoperative mean pain scores at 24 h rest were 2.1 in group III and 0.8 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.5 and 6.4, respectively [p < 0.001]. Postoperative mean pain scores at 24 h movement were 2.9 in group III and 1.6 in group IV. These pain scores were significantly lower than those in groups I and II, which were 7.5 and 7.3 respectively [p < 0.001]. The plasma lidocaine concentrations reached a maximum in groups III and IV 30 min after instillation begun. The highest mean plasma lidocaine level was 2.6 ug/ml [range 1.2 - 3.6]. In conclusions pain relief was inadequate in patients undergoing post-partum tubal ligation under local anesthesia, even after the administration of IM meperidine. Intraperitoneal lidocaine, however, effectively, decreased intraoperative and postoperative pain in these patients

Evaluation of the effect of I. M. lignocaine or bupivacaine on the hypnotic requirements of ketamine and propofol

We have studied the effect of i.m. lignocaine or bupivacaine on the hypnotic requirements of Ketamine and propofol in sixty patients of ASA I and II undergoing minor elective surgery under general anaesthesia. These patients were allocated randomly into two groups, ketamine group and propofol group. Each group was further subdivided into 3 subgroups A, B and C [n = 10 for each subgroup] where patients received saline, lignocaine or bupivacaine i.m. respectively before induction of anaesthesia. Anaesthesia was induced by ketamine or propofol in bolus doses of 0.2 mg/Kg every 30 sec. until loss of verbal response to verbal command was achieved. We found that lignocaine and bupivacaine significantly reduced the hypnotic doses of ketamine by 39.7% and 32.6% and that of propofol by 25.9% and 30.8% respectively. We concluded that the hypnotic doses of i.v. ketamine or propofol should be reduced if their administration is preceded by lignocaine or bupivacaine