Effect of premedication with lidocasine on the dose of atracurium and its reversal time

ABSTRACT

The effect of premedication with lidocaine as a local anaesthetic drug that used for blunting laryngeal reflexes and hypertensive reaction to laryngoscopy and intubation on the dose of atracurium as short acting non depolarizing muscle relaxant is investigated in this paper. At the same time we estimate its effect on the revesal and total assisted recovery time after administratikon of neostigmine as a cholinesterase inhibitor. Twenty adults, ASA physical before induction of anaesthesia. All the patients received thiopental 5 mg/kg. Atropine 0.01 mg/kg, 100% 0 and 0.5 mg/kg attracurium to facilitate intubation. Anaeshesia maintained by Halothane, 1%, O2 100%, and fentany 1 micro g/kg. Neuro muscular blockade was monitored by T.O.F. [train of four] stimulatikon using peripheral nerve stimulator. The reversal was done by neostigmine 0.07 mg/kg and atropine 0.01 mg/kg after appearances of first twitch of T.O.F. The total assisted recovery time [time from last incremental dose of atracurium till apperance of fourth twitch of T.OF. and reversal time [time from neostigmine abministration till apperence of fourth twitch of T.OF] were estimated. Statistics all parameters expressed by mean +/- stander deviation and correlation coefficient factor. The dose of atracurium expressed in mg/kg/hr. There was moderat reduction in the dose of atracurium in cases premedicated weith lidocaine [0.634 +/- 0.361] compared to control group [0.905 +/- 0.195] which equal 30%. There was non significant negative correlation between the dose of atracurium and the reversal time in lidocaine group. The same result was in control group. But there was a significant positive correlation between the dose of atracurium and total assisted recovery time in control group. This correlation was highly significant positive correlation in lidocaine group