Cardiovascular stability after epinephrine propranolol lidocaine infiltration in septoplasty operation in patients under nitrous oxide/02 opioid relaxant technique

ABSTRACT

Epinephrine infiltration is a common practice in ENT operations to produce haemostasis its concomittant administration with inhalational anaesthetics carries the risk to develop cardiac arrhythmias. This study was conducted to assess the cardiovascular stability after epinephrine propranolol-lidocaine infiltration in patients undergoing septoplasty operation under nitrous oxide nalbuphine relaxant technique. Forty ASA I adult patients of either sex were randomly allocated into two groups each of 20. Both groups received nitrous oxide [66%] in oxygen supplemented with nalbuphine 0.2 mg kg using atracurium 0.5 mg kg as the nuscle relaxant during maintenance of anaesthesia. First group received lidocaine 100 mg i.v. prior to infiltration of the nasal septum while the second group received nothing. infiltration of the nasal septum was done 10 minutes after intubation using 4 -5 ml of a solution containing epinephrine 1,00.000. lidocaine 1% plus propranolol 0.1 mg/ml. Patients were monitored as regards heart rate. systolic and diastolic blood pressures. Results showed insignificant changes in heart rate and blood pressure. No ventricular arrhythmias were seen. Lidocaine group showed more cardiovascular stability, in conclusion, epinephrine propranolol and lidocaine infiltration is almost safe during nitrous oxide opioid anaesthesia and lidocaine administration prior to infiltration confers upon more cardiovasculary stability