Laryngoscopy and intubation violates the patient's protective airway reflexes and lead to physiological changes involving various systems of the body. Reflex changes in the cardiovascular system are most marked after laryngoscopy and intubation and leads to average increase in blood pressure by 40-50% and 20% increase in heart rate (Indian J. Anaest 2002) 45(2):104-106. The present study compare the safe and clinically effective intravenous bolus dose of labetalol and lignocaine for controlling the cardiovascular response to laryngoscopy and intubation. METHODSA total of 90 normotensive adult consented patients aged 20-50 years, ASA grade I and grade II of both gender were randomized into three treatment groups of 30 patients each. Group I received normal saline 10 mL as infusion. Group II received 1.5 mg/kg body wt. of lignocaine hydrochloride one minute before intubation. Group III received 0.4 mg/kg body wt. of labetalol hydrochloride 5 minutes before intubation respectively. Anaesthetic technique was standardized and all groups were assessed for haemodynamic changes after the premedication before and after intubation, at the 1 st , 3 rd , 5 th and 10 th minute after intubation along with intraoperative haemodynamic stability and post-operative side effects. RESULTSSignificant increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed in group I after laryngoscopy and intubation. Statistically significant alteration of heart rate, systolic blood pressure and mean arterial pressure but no significant effect in the rise of diastolic blood pressure was observed respectively in group II, whereas statistically highly significant alternation of heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded in Group III. CONCLUSIONIntravenous bolus dose of labetalol is superior to lignocaine in attenuating the cardiovascular response to laryngoscopy and intubation. The study patients were haemodynamically stable perioperatively without prolongation of recovery time and side effects. KEYWORDSLabetalol, Lignocaine, Laryngoscopy, Intubation. HOW TO CITE THIS ARTICLE:Tayung RP, Laha AK, Talukdar TK, et al. Effect of intravenous labetalol in controlling the cardiovascular response to laryngoscopy and intubation: a comparison with intravenous lignocaine.
Objectives: The study was undertaken to observe the effect of intrathecally administered fentanyl with bupivacaine on onset and duration of sensory and motor block, quality of anaesthesia and requirement of analgesia during early postoperative period. Method: In this study 45 women of group 1 received hyperbaric bupivacaine 10 mg and 45 women of group 2 received bupivacaine 10mg with fentanyl 12.5 mg. Onset of sensory and motor block, height of block, sensory regression, requirement of analgesic and any complication were recorded. Result: The onset time for analgesia was significantly shorter in group 2 than in group1 (1.9±0.56 vs 2.46± 0.79). The mean time for sensory regression to L1 is shorter in group1 compared to group 2. The mean time for two segments sensory regression was significantly prolonged in group2 compared to group 1. Time for complete sensory recovery when rescue analgesia was required in postoperative period was significantly prolonged in group 2 compared to group 1 (259.4±35.3 vs 165.0±23.8). There were no significant differences between the two groups with regard to incidence of nausea and vomiting, shivering and pruritus. Conclusion: Addition of fentanyl to hyperbaric bupivacaine augments sensory block without affecting motor block.
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