P. T, Mydhili K
Sep 24, 2015
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Quality indicators
Journal
Journal of Evidence Based Medicine and Healthcare
Abstract
: AIM: The aim of the study is to compare the efficacy of intravenous Bolus dose of Esmolol Hydrochloride and Lignocaine Hydrochloride to attenuate the Haemodynamic responses to Laryngoscopy and Endotracheal intubation. MATERIALS & METHODS: A study of Esmolol hydrochloride and Lignocaine hydrochloride in attenuation of the cardiovascular response during Laryngoscopy and intubation was compared in 50 adult patient, undergoing surgery under general anaesthesia. This study was taken in 2 groups. Group - I consists of 25 patients, where Lignocaine hydrochloride 2 mg per kg IV was used for attenuation of cardiovascular response to Laryngoscopy and intubation. Group -II consists of 25 patients where Esmolol hydrochloride 200 mg IV bolus was used as study drug. RESULTS: Results of the present study are consistent with the studies in attenuating haemodynamic responses to Laryngoscopy and intubation by the use of intravenous bolus dose of 200 mg of Esmolol is superior to Lignocaine hydrochloride. 2mg per kg body weight IV bolus. CONCLUSION: It establishes the usefulness of intravenous bolus dose of Esmolol to attenuate the haemodynamic responses to Laryngoscopy and endotracheal intubation. This study shows the 200 mg of bolus dose of Esmolol hydrochloride is superior to intravenous Lignocaine hydrochloride 2 mg per kg body weight IV bolus to attenuate the haemodynamic responses to Laryngoscopy and endotracheal intubation. No side effects were noted with Esmolol and Lignocaine hydrochloride conduction block) greater than first degree, congestive heart failure, cardiac arrhythmias, history of angina, coronary artery diseases. DM, HTN and other major medical problems. Baseline heart rate <60/min, Baseline systolic BP <100mmHg, Treatment with beta blockers or calcium channel blockers, Hepatic/renal problems. This study was taken in 2 groups. Group - I consists of 25 patients, where Lignocaine hydrochloride 2mg per kg IV was used for attenuation of cardiovascular response to Laryngoscopy and intubation. Group -II consists of 25 patients where Esmolol hydrochloride 200 mg IV bolus was used as study drug. All the patients were assessed clinically preoperatively and investigated to rule out following problems. The following investigations were carried out before subjecting the patients for surgery, namely, complete Haemogram, urine analysis, Blood chemistry, electrocardiogram, and X-ray chest. PA view. All the patients were preoxygenated for 3 minutes, with 100% oxygen before induction of anaesthesia. Induction was achieved with injection thiopentone sodium 2.5% solution given in a dose of 5 mg per kg body weight. Further sequence varied between the two groups. In Group I after induction of anaesthesia with thiopentone sodium was followed with injection of Lignocaine hydrochloride (Without preservative) 2% in a dose of 2 mg per kg body weight, over a period of 10 seconds. Then blood pressure and pulse rate were recorded in all patients. This is followed by injection suxamethonium 1.5mg per kg body weight. After 60 seconds Laryngoscopy was performed and was intubated. The duration of Laryngoscopy was within 15-20 seconds. Patients in whom Laryngoscopy was difficult or in whom it exceeded 20 seconds were excluded from the study. Patients were then connected to and ventilated with closed circuit pressure post intubation was lower in the Esmolol 200 mg group (p < 0.05). They summarised that Esmolol 200 mg was effective in mitigating the haemodynamic response to tracheal intubation. Results of the present study are consistent with the above studies in attenuating haemodynamic responses to Laryngoscopy and intubation by the use of intravenous bolus dose of 200 mg of Esmolol is superior to Lignocaine hydrochloride. 2mg per kg body weight IV bolus. CONCLUSION: The following conclusions can be drawn from our study. It establishes the usefulness of intravenous bolus dose of Esmolol to attenuate the haemodynamic responses to Laryngoscopy and endotracheal intubation. This study shows the 200 mg of bolus dose of Esmolol hydrochloride is superior to intravenous Lignocaine hydrochloride 2 mg per kg body weight IV bolus to attenuate the haemodynamic responses to Laryngoscopy and endotracheal intubation. No side effects were noted with Esmolol and Lignocaine hydrochloride