A method for prevention of cardiovascular reactions to laryngoscopy and intubation

Abou-Madi, M.; Keszler, H; Yacoub, O.

doi:10.1007/bf03004841

Cited by 49 publications

(10 citation statements)

References 20 publications

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“…The methods also include adequate depth of anesthesia and brief duration of laryngoscopy. [ 12 ] In our study, intubation was performed when patient became unresponsive to verbal commands and twitch response monitored with the neuromuscular monitor disappeared, the duration of laryngoscopy and intubation was less than 15 s when performed in first attempt.…”

Section: Discussionmentioning

confidence: 97%

Attenuation of hemodynamic response to laryngoscopy and orotracheal intubation using intravenous clonidine

Sakshi

Kulkarni

Bhargava

2015

J Anaesthesiol Clin Pharmacol

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Background and Aims:Alpha-2 agonists are being increasingly used as adjuncts in general anesthesia and the present study was carried out to study the effect of clonidine as an adjuvant to low dose fentanyl in attenuating the hemodynamic response to laryngoscopy and orotracheal intubation.Materials and Methods:Ninety female patients belonging to American Society of Anesthesiologists (ASA) physical status I, II, and III in age group 25-65 years, body mass index (BMI) 21-26 kg/m2, and diagnosed as carcinoma breast scheduled for breast surgery were included in this Prospective, randomized, placebo-controlled study. One-way analysis of variance (ANOVA), paired t-test, and chi-square test was applied where deemed appropriate. P-value at or below the level of 0.05 was considered as statistically significant.Results:Intravenous (IV) clonidine 1.0 μg kg-1 and clonidine 2.0 μg kg-1 significantly attenuated the hyperdynamic response to laryngoscopy and intubation. Clonidine 2.0 μg kg-1 was associated with adverse effects like hypotension at the time of induction and postoperative sedation which was not observed with clonidine 1.0 μg kg-1.Conclusions:A single intravenous low dose clonidine (1.0 μg kg-1) when combined with low dose fentanyl (2 μg kg-1) is a practical, pharmacological and safe method with minimal side effects to attenuate the hyperdynamic response to laryngoscopy and intubation.

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Section: Discussionmentioning

confidence: 97%

Attenuation of hemodynamic response to laryngoscopy and orotracheal intubation using intravenous clonidine

Sakshi

Kulkarni

Bhargava

2015

J Anaesthesiol Clin Pharmacol

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“…En nuestro estudio con dosis de 2 mg/kg no se encontraron diferencias significativas respecto a la dosis usual de 1,5 mg/kg, manteniendo el concepto de reportes que comparan la respuesta hemodinámica de la lidocaína a dosis inferiores a 1,5 mg/kg. Abou-Madi, et al (9) concluyen que hay protección contra la hipertensión arterial y taquicardia como consecuencia de la IOT con lidocaína aplicada dos a tres minutos antes de la laringoscopia, así como el estudio de Hamaya et al (10) quienes también describen que lidocaína a 1,5 mg/ mg/kg disminuye la respuesta simpática resultado de la laringoscopia e intubación endotraqueal. Hidekazu Yukioka (11) demostró que la dosis de 2mg/kg de lidocaína endovenosa atenuaba la tos o "pujo" en la laringoscopia e intubación, aspecto que no fue medido en nuestro estudio pues nos basamos en cambios de tensión arterial y frecuencia cardiaca.…”

Section: Discussionunclassified

“…Al igual que los estudios reportados en la literatura (12)(13)(14)(15) no se evidenciaron efectos adversos dentro de este estudio a pesar del incremento de la dosis de lidocaína a 2 mg/kg.…”

Section: Discussionunclassified

Lidocaína Endevenosa en prevención de hipertención arterial y taquicardia en pacientes intubados adultos ASA I y II bajo anestesia general

Tocancipá

Silva

2010

RFS

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Introducción: la laringoscopia e intubación endotraqueal (IOT) predisponen a complicaciones cardiocerebrales por liberación de catecolaminas. La lidocaína, económica y ampliamente disponible, tiene efecto protector controversial a dosis bajas (< 1,5 mg/k de peso). Se plantea su efecto en atenuar el aumento de frecuencia cardiaca y tensión arterial durante estos procedimientos, aumentando la dosis a 2 mg/k, aprovechando su amplia ventana terapéutica. Objetivos: comparar la variación hemodinámica durante la IOT al aplicar lidocaína 1,5 mg/K versus 2 mg/k. Materiales y métodos: ensayo clínico aleatorizado doble ciego con 30 pacientes a cada grupo de comparación (error alfa 0,05 y poder del estudio del 80%). El grupo control recibió lidocaína 1,5 mg/k y el grupo estudio 2 mg/k durante la inducción anestésica. Todos recibieron propofol, fentanil y rocuronio. Se midió la frecuencia cardiaca (FC), tensión arterial sistólica (TAS), tensión arterial diastólica (TAD) y tensión arterial media (TAM) basal, durante la IOT y cada minuto hasta el minuto 5. Se analizó en epi-info 3.2.1. Resultados: hubo menor alteración hemodinámica en el grupo lidocaína 2 mg/k sin diferencias estadísticamente significativas para todos los desenlaces: FC (74,6 versus 75,7, p = 0,75), TAS (119,7 versus 120,3, p = 0,78), TAM (85,7 versus 87,1, p = 0,72) y TAD (68,7 versus 68,8, p = 0,72). Conclusiones: no hubo diferencias hemodinámicas clínicas ni estadísticamente significativas durante la intubación orotraqueal de pacientes ASA I y II llevados a cirugía bajo anestesia general, al usar lidocaína a 2 mg/k versus 1,5 mg/k.

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“…It manifests as an increase in heart rate, blood pressure, and cardiac complications. [2] Attenuation of these responses by intravenous lignocaine found some studies effective[34] and in some studies less reliable. [56] Use of esmolol is effective in blunting pressor response and provides hemodynamic stability in risk patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a bolus dose of esmolol and bolus dose of lignocaine for attenuating the pressor response to laryngoscopy and endotracheal intubation in general anesthesia: A comparative study

et al. 2019

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Context: Laryngoscopy and endotracheal intubation result in an increase in heart rate and blood pressure; they evoke life-threatening complications. The esmolol is short-acting cardioselective beta-blocker and brings advantages to the perioperative management of tachycardia and hypertension. Aims: The aim of this study was to compare the efficacy of a bolus dose of esmolol and bolus dose of lignocaine for attenuation of the pressor response to laryngoscopy and intubation. Settings and Design: Sixty patients of both sex, aged 20–50 years, belonging to the American Society of Anesthesiologists physical Status I and II randomly allocated into two groups ( n = 30). Materials and Methods: The study drugs diluted in 10-ml normal saline. Group I received esmolol 1.5 mg/kg and Group II received lignocaine 1.5 mg/kg 2 min before inducing the patients with thiopentone 5 mg/kg and suxamethonium 1.5 mg/kg. The heart rate, systolic blood pressure, and diastolic blood pressure were measured at basal, during intubation, and 1, 2, 3, and 5 min after intubation, and based on these values, the mean arterial pressure (MAP) and rate pressure product (RPP) was calculated. Statistical Analysis Used: The Student's t -test and data were represented by mean standard deviation and graphs. Results: The mean pulse rate, mean of MAP, and mean of RPP at intubation and at 1, 2, 3, and 5 min after intubation in lignocaine group showed a significant rise in these values but in esmolol group it remained nearer to or less than baseline values. Conclusions: Esmolol 1.5 mg/kg is effective in attenuating the pressor response in comparison with lignocaine 1.5 mg/kg during laryngoscopy and intubation.

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A method for prevention of cardiovascular reactions to laryngoscopy and intubation

Cited by 49 publications

References 20 publications

Attenuation of hemodynamic response to laryngoscopy and orotracheal intubation using intravenous clonidine

Attenuation of hemodynamic response to laryngoscopy and orotracheal intubation using intravenous clonidine

Lidocaína Endevenosa en prevención de hipertención arterial y taquicardia en pacientes intubados adultos ASA I y II bajo anestesia general

Efficacy of a bolus dose of esmolol and bolus dose of lignocaine for attenuating the pressor response to laryngoscopy and endotracheal intubation in general anesthesia: A comparative study

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