Original Research Article
Year: 2017 | Month: February | Volume: 4 | Issue: 2 | Pages: 47-55
Comparative Study of Intravenous Lignocaine and Intravenous Magnesium Sulphate in Attenuating Stress Response to Laryngoscopy and Intubation
Dr. Shweta Bulle1, Dr. B.D. Bande2
1Assistant Professor, Department of Anesthesia, GMC Nagpur
2Consultant and Intensivist, Department of Anesthesia, KEM Hospital, Pune
Corresponding Author: Dr. Shweta Bulle
Background and Aims: Laryngoscopy and tracheal intubation are associated with an increase in heart rate, systemic blood pressure, pulmonary arterial pressure and capillary wedge pressures. These hemodynamic changes are well tolerated in normotensive individuals, but are of greater significance in patients with coronary artery disease and cerebrovascular disorders, and have been recognized as a potential source of a number of complications.
Methods: This randomized study was done to compare and evaluate the efficacy of Lignocaine and Magnesium sulphate to attenuate the cardiovascular response to endotracheal intubation in ASA I patients. This study included 60 patients of ASA grade I aged between 15 and 45 years, scheduled for elective surgery under general anesthesia. Patients were randomized into two groups of 30 each. There was no significant difference in demographic or baseline hemodynamic variables between the two groups. Group L received i.v. Lignocaine in the dose of 1.5mg/kg 3 minutes before induction and Group M received i.v. Magnesium sulphate 40mg/kg over 1 minute just before induction.
Results: We found a significant rise in heart rate in both the groups but the rise was significant in Lignocaine group as compared to Magnesium group. (p value < 0.01) There was rise in systolic blood pressure immediately after drug administration in both the groups (p value < 0.05). It remained significant at 1 minute after intubation but returned to baseline at 3 minutes, which dropped below baseline at 5 minutes post intubation in group M. In group L significant rise in SBP at 1 and 3 minutes was observed which returned to baseline at 5 minutes post intubation. The rise in SBP was significantly higher in group L as compared to group M (p value < 0.05)The rise in DBP was observed in both the groups upto 3 minutes after intubation (p value < 0.01) which further dropped below baseline in either groups (p value < 0.05). The progressive rise was significant in group L as compared to group M (p value < 0.01)
Conclusion: Magnesium sulphate provides fairly good and sustained control over rise in HR, SBP and DBP during laryngoscopy and tracheal intubation in ASA grade I patients as compared to Lignocaine.
Key words: Intravenous Lignocaine, Intravenous Magnesium Sulphate, Stress Response, Laryngoscopy, Intubation.[PDF Full Text]